ORIGINAL ARTICLE   

Chirurgia 2021 April;34(2):61-5

DOI: 10.23736/S0394-9508.20.05098-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Beyond diabetes mellitus type 2: neuropathy, arterial disease and foot deformity

Hosein HEMMATI ^{1, 2}, Mobin FORGHAN ², Zahra ABBASI RANJBAR ³, Zakiyeh JAFARYPARVAR ², Elahe RAFIEI ⁴, Sasan ANDALIB ^{5, 6, 7, 8} ✉

¹ Vascular Surgery and Dialysis Research Center, Guilan University of Medical Sciences, Rasht, Iran; ² Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran; ³ Department of Endocrinology and Metabolism, Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran; ⁴ Vice-Chancellery of Research and Technology, Guilan University of Medical Sciences, Rasht, Iran; ⁵ Neuroscience Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran; ⁶ Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; ⁷ Trauma Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran; ⁸ Research Unit of Clinical Physiology and Nuclear Medicine, Department of Clinical Research, Odense University Hospital, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

BACKGROUND: Neuropathy, foot deformity, and vascular disease of foot arise from diabetes mellitus type 2 (DM2). In the present study, we evaluated neuropathy, foot deformity, and vascular disease of foot and other relevant factors in patients with DM2.
METHODS: In this cross-sectional study, 123 subjects with DM2 were evaluated in a referral therapeutic center in Guilan province of Iran. Semmes-Weinstein monofilament testing, ankle brachial index, bidimensional plantar scan were used for evaluation of neuropathy, peripheral arterial disease, and deformity of feet, respectively. The subjects were categorized for diabetic foot risk level according to International Working Group on the Diabetic Foot (IWGDF) criteria.
RESULTS: The average age of the patients was 66 years and 56.9% of the subjects were females. Furthermore, 58% of the subjects used insulin injection for treatment of DM2, while 29.3% of the patients had normal Body Mass Index and 40.7% and 43% of the patients experienced sensory neuropathy and arterial disease. Also, 82.9% of the patients suffered foot deformities, of which 33.3 and 19.6% experienced flatfoot and hallux rigidus, respectively. Age, disease duration, chronic kidney disease, muscle weakness, and HbA1C level were associated with higher IWGDF risk level.
CONCLUSIONS: Neuropathy, arterial disease and deformity of feet, in addition to disease duration and lack of management intensified diabetic patients’ problems. Higher prevalence of flatfoot and other relevant problems necessitate attention to diabetic foot ulcers in Iran.

KEY WORDS: Diabetes mellitus, type 2; Arteries; Foot ulcer