Periphere arterielle Verschlusskrankheit bei Diabetes mellitus Typ 1 und Typ 2: Unterscheiden sich die Risikofaktoren?

Zander,; Heinke,; Reindel,; Kohnert,; Kairies,; Браун,; Eckel,; Kerner,

doi:10.1024/0301-1526.31.4.249

Cited by 35 publications

(6 citation statements)

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“…Nevertheless, PAD lesion characteristics of subjects appear to be broadly similar, allowing for sound comparisons. Thirdly, although all studies did not specify the types of diabetes included and their relative proportions within the cohort, this appears not to be a confounding factor as no discernible differences were found in the micro‐ and macrovascular comorbidities between patients with type 1 and type 2 diabetes [48]. Lastly, relating solely to Acín et al [38]'s study, it is equivocal as to how the inclusion of subjects with femoropopliteal lesions had influenced their findings.…”

Section: Discussionmentioning

confidence: 99%

The comparative efficacy of angiosome‐directed and indirect revascularisation strategies to aid healing of chronic foot wounds in patients with co‐morbid diabetes mellitus and critical limb ischaemia: a literature review

Khor

Price

2017

Journal of Foot and Ankle Research

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BackgroundIschaemic ulcerations have been reported to persist and/or deteriorate despite technically successful revascularisations; a higher incidence of which affects patients with diabetes and critical limb ischaemia. In the context of wound healing, it is unclear if applications of the angiosome concept in ‘direct revascularisation’ (DR) would be able to aid the healing of chronic foot ulcerations better than the current ‘best vessel’ or ‘indirect revascularisation’ (IR) strategy in patients with co-morbid diabetes and critical limb ischaemia.MethodsA literature search was conducted in eight electronic databases, namely AMED, CINAHL, The Cochrane Library, ProQuest Health & Medicine Complete, ProQuest Nursing & Allied Health Source, PubMed, ScienceDirect and TRIP database. Articles were initially screened against a pre-established inclusion and exclusion criteria to determine eligibility and subsequently appraised using the Newcastle-Ottawa Scale.ResultsFive retrospective studies of varying methodological quality were eligible for inclusion in this review. Critical analysis of an aggregated population (n = 280) from methodologically stronger studies indicates better wound healing outcomes in subjects who had undergone DR as compared to IR (p < 0.001; p = 0.04). DR also appears to result in a nearly twofold increase in probability of wound healing within 12 months (hazard ratio, 1.97; 95% CI, 1.34–2.90). This suggests that achieving direct arterial perfusion to the site of ulceration may be important for the healing of chronic diabetic foot ulcerations.ConclusionIncorporating an angiosome-directed approach in the lower limb revascularisation strategy could be a very useful adjunct to a solely indirect approach, which could increase the likelihood of wound healing. With the limited data currently available, findings appear promising and merit from further investigation. Additional research to form a solid evidence base for this revised strategy in patients with co-morbid diabetes and critical limb ischaemia is warranted.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-017-0206-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The comparative efficacy of angiosome‐directed and indirect revascularisation strategies to aid healing of chronic foot wounds in patients with co‐morbid diabetes mellitus and critical limb ischaemia: a literature review

Khor

Price

2017

Journal of Foot and Ankle Research

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“…СД1 тесно ассоциируется с риском развития заболевания периферических артерий (ЗПА). При наличии ДН относительный риск формирования ЗПА увеличивается в 3 раза, при длительности диабета 20-29 летв 28,9 раза, более 30 лет -в 51,1 раза [35]. По данным различных исследований, от 23 до 45,9% диализных пациентов страдают ЗПА [36].…”

Section: оценка сердечно-сосудистой системы -ахиллесова пята подготовки пациента к трансплантации почкиunclassified

Preparation of the dialysis patient with type 1 diabetes mellitus for kidney transplantation

Martynov

Severina

Larina

et al. 2020

Probl Endokrinol (Mosk)

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Kidney transplantation is unique method of renal replacement therapy, allowing to improve quality and duration of life for patients with diabetes mellitus type 1 (DM1) and end-stage renal disease (ESRD) on dialysis therapy. Recently using of innovation technologies for diabetes management and modern immunosuppression enable achieving better results of posttransplant rehabilitation for patients with DM1, especially if kidney transplantation is performed early after initiation of dialysis. Detailed examination of patient with DM1 before potential kidney transplantation is very important to reduce of early and late postoperative complications. Kidney transplantation preparation includes effective glycemic control, adequate dialysis therapy, treatment of diabetes and ESRD complications and concomitant conditions, especially cardiovascular diseases, accounting for kidney transplantation perspective. Furthermore, diagnostics and treatment of any infectious process, timely vaccination, cancer screening are basic approaches of kidney transplantation preparation program, providing the best survival rate of kidney graft and patient.

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“…There is increased all-cause and cardiacrelated mortality risk, similar to that in non-diabetic patients described above, and abnormal ABPI is also associated with the presence of the microvascular complications of diabetes such a nephropathy, neuropathy and retinopathy. 27 ABPI in other pathology…”

Section: Abpi In Diabetic Patientsmentioning

confidence: 99%

Ankle Brachial Pressure Index: An update for the vascular specialist and general practitioner

Thurston

Dawson

2019

Vascular

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Objectives Ankle brachial pressure index (ABPI) is an invaluable tool for assessing the severity of peripheral arterial disease. In addition, it can be used as an independent marker of cardiovascular risk, with a predictive ability similar to the Framingham criteria. Identification of an abnormal ABPI should therefore trigger aggressive cardiac risk factor modulation for a patient. Unfortunately, the significance of abnormal ABPIs is poorly understood within the general medical community. This is compounded by the influence of various comorbidities on accurate measurement of ABPI, potentially leading to a wide variability in readings that need to be considered before interpretation in these patient populations. We aim to address these issues by revealing several common misunderstandings and pitfalls in ABPI measurement, describing accurate methodology, and highlighting patient cohorts in whom additional or alternative approaches may be required. Methods We present a narrative review of the role of ABPI in both the community and hospital setting. We have performed a literature review, exploring the validity and reproducibility of methodology for obtaining ABPI, alongside the utility of ABPI in different clinical scenarios. Results The measurement of ABPI is often performed incorrectly. Common pitfalls include inadequate patient preparation, failure to obtain the blood pressure from the correct lower limb artery in patients with tibial disease, failure to account for differences in brachial blood pressure between the arms, inappropriately chosen equipment and patient factors such as highly calcified arteries. Standardisation of methodology greatly improves reliability of the test. Exercise ABPI can identify significant peripheral arterial disease in patients with normal resting ABPI. In addition to its role in peripheral arterial disease, ABPI measurement has a role in assessing venous ulcers, entrapment syndromes and injured extremities; conversely, it has a more limited utility in the diabetic population. Conclusions A thorough understanding of the correct technique and associated limitations of ABPI measurement is essential in accurately generating and interpreting the data it provides. With this knowledge, the ABPI is an invaluable tool to help manage patients with peripheral arterial disease. Perhaps more importantly, ABPI can be used to identify and risk stratify patients with asymptomatic peripheral arterial disease, itself a major indicator of significant underlying cardiovascular disease. With the emergence of best medical therapy, targeted pharmacotherapy and lifestyle changes can reduce the risk of major cardiovascular events in high-risk patients by approximately 30%, particularly in diabetic patients. Therefore, the utility of ABPI transgresses vascular surgery, with an essential role in general practice and public health.

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Periphere arterielle Verschlusskrankheit bei Diabetes mellitus Typ 1 und Typ 2: Unterscheiden sich die Risikofaktoren?

Abstract: PAD risk factors and micro- and macrovascular comorbidity are very similar in type 1 and type 2 diabetes.

Cited by 35 publications

References 0 publications

The comparative efficacy of angiosome‐directed and indirect revascularisation strategies to aid healing of chronic foot wounds in patients with co‐morbid diabetes mellitus and critical limb ischaemia: a literature review

The comparative efficacy of angiosome‐directed and indirect revascularisation strategies to aid healing of chronic foot wounds in patients with co‐morbid diabetes mellitus and critical limb ischaemia: a literature review

Preparation of the dialysis patient with type 1 diabetes mellitus for kidney transplantation

Ankle Brachial Pressure Index: An update for the vascular specialist and general practitioner

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