The Independent Contributions of Diabetic Neuropathy and Yasculopatny in Foot Ulceration: How great are the risks?

McNeely, Marguerite J.; Boyko, Edward J.; Ahroni, Jessie H.; Stensel, Victoria L; Reiber, Gayle E.; Smith, Douglas G.; Pecoraro, Roger E.

doi:10.2337/diacare.18.2.216

Cited by 336 publications

(242 citation statements)

References 7 publications

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“…However, care must be taken with the interpretation of the amputation data due to the low number of events (n ϭ 19). Numerous studies have shown the importance of the 10-g Semmes Weinstein monofilament (which assesses cutaneous pressure perception) as a predictor for foot ulceration (3,7,13,19) and LLA (6). Our study confirms this latter finding for LLA and adds more evidence to the use of simple monofilament pressure testing in all people with diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Both the micro-and macrovascular systems can be affected by PVD in diabetes, and transcutaneous partial pressure of oxygen (TcpO 2 ) can predict diabetic foot ulceration (7). TcpO 2 , ankle brachial pressure index (ABPI), diminished lowerlimb pulses, and medial arterial calcification are also independent risk factors for LLA (6,8).…”

mentioning

confidence: 99%

“…PN affects sensory, motor, and autonomic sections of the peripheral nervous system and can be assessed in a variety of ways (1,5,11,12). Vibration perception threshold (VPT), pressure perception threshold (PPT), temperature perception threshold (TPT), autonomic neuropathy, muscle strength, reflexes, and neuropathy disability score all predict foot ulceration to some degree (1)(2)(3)(4)(5)7,13). In addition, lower-limb amputation (LLA) can be predicted by VPT, PPT, and reflexes (6,8).…”

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confidence: 99%

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Can Motor Nerve Conduction Velocity Predict Foot Problems in Diabetic Subjects Over a 6-Year Outcome Period?

et al. 2002

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OBJECTIVE -This study examined motor nerve conduction velocity (MNCV) and other peripheral nerve and vascular tests as predictors for foot ulceration, amputation, and mortality in diabetes over a 6-year follow-up period.RESEARCH DESIGN AND METHODS -We recruited 169 diabetic subjects (without significant peripheral vascular disease with an ankle brachial pressure index [ABPI] Ն0.75) for the study and separated them into groups (to ensure diversity of nerve function). The control group consisted of 22 nondiabetic people. At baseline, all subjects underwent assessment of MNCV; vibration, pressure, and temperature perception thresholds; peripheral vascular function; and other diabetes assessments.RESULTS -Over the 6-year outcome period, 37.3% of the diabetic subjects developed at least one new ulcer, 11.2% had a lower-limb amputation (LLA) (minor or major), and 18.3% CONCLUSIONS -This study shows that MNCV, which is often assessed in clinical trials of neuropathy, can predict foot ulceration and death in diabetes. In addition, tests of PPT and medial arterial calcification can be used in the clinic to predict LLA in diabetic subjects. Diabetes Care

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confidence: 99%

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Can Motor Nerve Conduction Velocity Predict Foot Problems in Diabetic Subjects Over a 6-Year Outcome Period?

et al. 2002

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“…A avaliação dos pés constitui-se em passo fundamental na identificação dos fatores de risco que podem ser modificados, o que, conseqüen-temente, reduzirá o risco de ulceração e amputação de membros inferiores nas pessoas com diabetes (30) . Autores destacam que a diminuição da sensação protetora, caracterizada pela redução da sensação dolorosa de trauma na pele (3,(32)(33)(34)(35)(36)(37) , bem como a ausência parcial ou total do reflexo Aquileu (14,26,(38)(39) constituem sinais precoces de futuros processos ulcerativos nos pés, significando alto risco para o desenvolvimento de complicações. Ambas as alterações podem ser avaliadas mediante testes que utilizam vários tipos de instrumentos, desde os mais sofisticados aos mais simples.…”

Section: Avaliação Dos Pés E Prevenção De Complicaçõesunclassified

Pé diabético: estratégias para prevenção

Ochoa-Vigo

Pace

2005

Acta paul. enferm.

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Ochoa-Vigo K, Pace AE. Pé diabético: estratégias para prevenção. Acta Paul Enferm 2005; 18(1):100-9.RESUMO: Aproximadamente 50% das amputações não-traumáticas em membros inferiores ocorrem entre pessoas com diabetes. As amputações são precedidas por úlceras, caracterizadas por lesões cutâneas, com perda do epitélio, que podem estender-se até a derme ou chegar a tecidos profundos. As úlceras, geralmente, são acompanhadas de insensibilidade por neuropatia periférica crônica e associadas a pequenos traumas que se originam do uso de calçados inapropriados, dermatoses comuns ou manipulações incorretas dos pés. O objetivo deste estudo é descrever as principais estratégias para avaliar fatores de risco que conduzem ao desenvolvimento de complicações nos membros inferiores entre pessoas com diabetes, bem como considerá-las uma responsabilidade da equipe de assistência primária. É um trabalho de revisão da literatura, com ênfase na avaliação dos pés como medida preventiva fundamental, para identificar, precocemente, as alterações neurológica e vascular periféricas e disfunções biomecânicas. Destaca-se a avaliação dos calçados como fator externo.

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“…Intermittent claudication of the calf or the sole of the foot, pain of decubitus which eases on reclining have good diagnostic values. But an arteritis frequently associated with a peripheral neuropathy 4 and the absence of pain does not exclude the diagnosis.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Surgical revascularization techniques for diabetic foot

Kota¹,

Kota²,

Meher³

et al. 2013

Journal of Cardiovascular Disease Research

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a b s t r a c tDiabetes is an important risk factor for atherosclerosis. The diabetic foot is characterized by the presence of arteriopathy and neuropathy. The vascular damage includes non-occlusive microangiopathy and macroangiopathy. Diabetic foot wounds are responsible for 5e10% of the cases of major or minor amputations. In fact, the risk of amputation of the lower limbs is 15e20% higher in diabetic populations than in the general population. The University of Texas classification is the reference classification for diabetic wounds. It distinguishes non-ischemic wounds from ischemic wounds which are associated with a higher rate of amputation. The first principles of treatment are the control of pain of an eventual infection. When ischemia is diagnosed, restoration of pulsatile blood flow by revascularization may be considered for salvaging the limb. The treatment options are angioplasty with or without stenting and surgical bypass or hybrid procedures combining the two. Distal reconstructions with anastomosis to the leg or pedal arteries have satisfactory limb-salvage rates. Subintimal angioplasty is a more recent endovascular technique. It could be suggested for elderly patients who are believed to be unsuitable candidates for a conventional bypass or angioplasty. The current article would focus on the various revascularization procedures.

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The Independent Contributions of Diabetic Neuropathy and Yasculopatny in Foot Ulceration: How great are the risks?

Cited by 336 publications

References 7 publications

Can Motor Nerve Conduction Velocity Predict Foot Problems in Diabetic Subjects Over a 6-Year Outcome Period?

Can Motor Nerve Conduction Velocity Predict Foot Problems in Diabetic Subjects Over a 6-Year Outcome Period?

Pé diabético: estratégias para prevenção

Surgical revascularization techniques for diabetic foot

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