[Diabetic foot and risk factors].

Area of Science:

• Endocrinology
• Vascular Medicine
• Diabetology

Background:

• Diabetic foot complications, including neuropathy and peripheral arterial disease (PAD), significantly impact patient quality of life.
• Identifying specific risk factors is crucial for targeted interventions in diabetic foot care.

Purpose of the Study:

• To determine clinical and metabolic risk factors associated with diabetic neuropathy and peripheral arterial disease (PAD) in patients managed at a diabetic foot unit.
• To compare patient characteristics across groups defined by the presence or absence of these complications.

Main Methods:

• A cohort of 304 diabetic patients were evaluated between 2000 and 2005.
• Diabetic neuropathy assessed via monofilament, tuning fork, and Boulton's scale; PAD assessed using ankle-brachial index (ABI) and toe-brachial index (TBI).
• Patients categorized into four groups: normal, neuropathic, vascular (PAD), and mixed (neuropathy and PAD); demographic and clinical data analyzed.

Main Results:

• Older age, hypertension, and coronary disease were significantly more prevalent in patients with PAD (vascular and mixed groups).
• Higher frequencies of retinopathy, nephropathy, and elevated HbA1c levels were observed in patients with diabetic neuropathy (neuropathic and mixed groups).
• Worse metabolic control (higher HbA1c) was associated with diabetic neuropathy.

Conclusions:

• Diabetic neuropathy development is associated with poorer glycemic control and existing microvascular complications.
• Age, hypertension, and coronary heart disease are identified as key risk factors for developing peripheral arterial disease in diabetic patients.
• These findings underscore the importance of comprehensive risk factor management in preventing diabetic foot complications.