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Poor vision as a contributory factor in diabetic neuro-arthropathy
1Department of Medicine, Manchester Royal Infirmary, UK.
Diabetes Research and Clinical Practice
|November 5, 1997
Summary
Patients with diabetes and poor vision are at higher risk for Charcot neuro-arthropathy. Early X-rays are crucial for diagnosing foot fractures and preventing this serious complication.
Area of Science:
- Diabetology
- Podiatry
- Neurology
Background:
- Insulin-dependent diabetes mellitus (IDDM) can lead to complications like neuropathy, nephropathy, and retinopathy.
- Poor vision in diabetic patients may increase the risk of foot injuries.
Observation:
- Two patients with longstanding IDDM and vision impairment presented with swollen, painless feet after walking on uneven ground.
- Initial presentations missed subtle foot injuries, including an undisplaced navicular fracture.
Findings:
- Both patients subsequently developed midfoot Charcot neuro-arthropathy within weeks.
- Undiagnosed foot fractures in patients with diabetes and poor vision are significant risk factors for Charcot development.
Implications:
- Emphasizes the importance of plain radiographs in evaluating swollen, insensitive feet, even without pain.
- Highlights poor vision as a potential risk factor for Charcot neuro-arthropathy in diabetic patients.
- Suggests a need for heightened vigilance and diagnostic imaging in diabetic patients with visual impairment presenting with foot swelling.