Assessment of Diabetic Polyneuropathy and Plantar Pressure in Patients with Diabetes Mellitus in Prevention of Diabetic Foot

Abstract

Introduction:Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities.Material and methods:In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot.Results:Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That’s a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05).Conclusion:A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes.

Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing

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Assessment of the Plantar Pressure, Muscle Strength and Balance in Patients with Type 2 Diabetes Mellitus in Cyprus

“…A healthy foot assessment is essential in patients with DM to determine biomechanical sways and incorrect distribution of plantar pressure [18]. Thus, ulceration and even amputation in lower limb may be prevented.…”

Risk factors associated with Loss of Protective Sensitivity in Diabetes patients in the Multidisciplinary Unit of Diabetic Foot

“…Amira et al, en el año 2014 en su estudio "Evaluación de la polineuropatía diabética y la presión plantar en pacientes con DM en la prevención del pie diabético", un estudio prospectivo, que incluyó 100 pacientes con DM tipo 2, evaluaron neuropatía diabética, la función dinámica del pie (presión plantar) y los factores de riesgo asociados. En esta población la mayoría tenía más de 50 años, con predominio femenino, HbA1c > 7, más de 10 años de enfermedad y la prevalencia polineuropatía diabética con test del monofilamento fue del 65% (22), cifra alejada de nuestro hallazgo de 33% con la salvedad de la diferencia en el diseño de estudio. En un estudio realizado en el Hospital Nacional de Itauguá, Paraguay, en el año 2015 denominado "Factores de riesgo asociados al pie diabético" se incluyeron 86 pacientes, de los cuales el 57% presentó neuropatía.…”