Diabēta pēdas incidence, izpausmes un problēmas I tipa cukura diabēta pacientiem
Date
2018
Authors
Kalniņa, Daina
Journal Title
Journal ISSN
Volume Title
Publisher
Latvijas Universitāte
Abstract
Darba aktualitāte: Pasaulē vairāk nekā 285 miljoni cilvēku slimo ar 1.tipa cukura diabētu un katru gadu incidence paaugstinās par 3-5% gadā. Tā kā vairāk kā 50% pacientu ir diabēta polineiropātija, kas daļai populācijas manifestējas ar pēdu čūlām un nepieciešamību veikt amputāciju, tad svarīgi ir izanalizēt riska faktorus, lai preventīvi izglītotu kā medicīnas darbiniekus, tā pacientus. Darba mērķis: uzzināt pacientu izglītības līmeni par glikēto hemoglobīnu un novērtēt diabēta pēdas veicinošos faktorus un incidenci 1.tipa cukura diabēta slimniekiem. Materiāli un metodes: Retrospektīvā pētījumā tika analizētas slimības vēstures ar 1.tipa cukura diabētu no 4 slimnīcām, laika posmā no 2015.-2017.gadam. No slimības vēsturēm reģistrētie dati: vecums, dzimums, diabēta stāžs, glikētais hemoglobīns, sirds un asinsvadu slimības anamnēzē, ķermeņa masas indekss, diabēta komplikāciju, pēdas deformāciju, čūlu esamība, lietotie medikamenti diabēta polineiropātijas ārstēšanai un amputācijas veikšana anamnēzē. Pēc slimības vēstures datu ievākšanas, pacientiem tika veikta telefoniska aptauja, lai noskaidrotu, vai laika gaitā dati nav mainījušies, zināšanas par glikēto hemoglobīnu, tā kontroles biežumu, precizēti dati. Datu analizēšanai tika izmantota statistikas programma SPSS 22.versija. Rezultāti: Pētījumā apkopoti dati par 526 pacientiem ar 1TCD. Vidējais vecums 39,9 gadi (+/-15). Vidējais 1TCD ilgums 15,9 gadi (+/-13). Vidējais HbA1C 9,5% (+/-2). 78% pacientu zināja, kas ir glikētais hemoglobīns un 88% no tiem šo mērījumu noteica 4x/gadā. 68% bija normāls ĶMI. 35,9% anamnēzē bija vismaz viena no sirds un asinsvadu slimībām. No CD mikrovaskulārajām komplikācijām, visbiežāk sastopamā bija polineiropātija (56%), otra biežākā bija retinopātija (37%), visretāk sastopamā bija nefropātija (23,6%). 13 pacientiem tika konstatētas kāju čūlas un 13 pacientiem tika veiktas apakšējās ekstremitātes amputācijas. Tika konstatēta statistiski nozīmīga korelācija starp diabēta ilgumu, metabolo kompensāciju un DPN incidenci. Secinājumi: Diabēta polineiropātijas un amputācijas biežums tiek vairāk novērots pacientiem ar lielāku vecumu, diabēta stāžu un sliktāk kontrolētu glikozes līmeni asinīs. Polineiropātija attīstās kā pirmā cukura diabēta mikrovaskulārā komplikācija, taču lielākajai daļai pacientu ar diabēta čūlām un apakšējās ekstremitātes amputācijām bija arī diabēta retinopātija un nefropātija. Ateroskleroze palielina risku diabēta pēdas attīstībai.
Author: Daina Kalnina Name of the study: The incidence, manifestations, and problems of diabetic foot in type 1 diabetes mellitus patients Background: Over 285 million people in the world are suffering from type 1 diabetes and the number increases by 3-5% each year. More than 50% of patients have diabetic polyneuropathy and part of the population manifest with foot ulcers and the need for amputation. It is important to analyze the risk factors for the prevention of both medical staff and patients. Aim: To find out the knowledge of type 1 diabetes patients about glycosylated hemoglobin and to evaluate the factors contributing diabetic foot and DF incidence in type 1 diabetes. Materials and methods: In a retrospective cohort study were analyzed four hospitals. A patient history analysis was carried out during the period from 2015 to 2017. Registered data: age, gender, duration of diabetes, glycosylated hemoglobin, history of cardiovascular disease, body mass index, diabetes complications, foot deformity, the presence of ulcers, used drugs for the treatment of diabetic polyneuropathy and history of amputation. Subsequently, a telephone survey was conducted to determine if the data has changed over time and to find out patients understanding of glycosylated hemoglobin. Analysis was done using SPSS version 22.0. Results: The study summarizes data about 526 patients with 1TCD. The average age is 39.9 years (+/- 15). Average 1TCD duration 15.9 years (+/- 13). The mean HbA1C is 9.5% (+/- 2). 78% of patients knew what glycosylated hemoglobin is and 88% of them measured 4x / year. 68% of patients had normal BMI. 35.9% had a history of at least one of the cardiovascular diseases. The most frequent of the microvascular complication of the CD was polyneuropathy (56%), the second most commonly was retinopathy (37%), the less common was nephropathy (23.6%). 13 patients had foot ulcers and 13 patients had lower limb amputation. A statistically significant correlation was found between the duration of diabetes, metabolic compensation and DPN incidence. Conclusions: The incidence of diabetic polyneuropathy and amputation is more common in patients with higher age, duration of diabetes and poorly controlled blood glucose. Polyneuropathy develops as the first microvascular complication of diabetes, but most patients with diabetes and lower limb amputations also had diabetic retinopathy and nephropathy. Atherosclerosis increases the risk of developing diabetic foot.
Author: Daina Kalnina Name of the study: The incidence, manifestations, and problems of diabetic foot in type 1 diabetes mellitus patients Background: Over 285 million people in the world are suffering from type 1 diabetes and the number increases by 3-5% each year. More than 50% of patients have diabetic polyneuropathy and part of the population manifest with foot ulcers and the need for amputation. It is important to analyze the risk factors for the prevention of both medical staff and patients. Aim: To find out the knowledge of type 1 diabetes patients about glycosylated hemoglobin and to evaluate the factors contributing diabetic foot and DF incidence in type 1 diabetes. Materials and methods: In a retrospective cohort study were analyzed four hospitals. A patient history analysis was carried out during the period from 2015 to 2017. Registered data: age, gender, duration of diabetes, glycosylated hemoglobin, history of cardiovascular disease, body mass index, diabetes complications, foot deformity, the presence of ulcers, used drugs for the treatment of diabetic polyneuropathy and history of amputation. Subsequently, a telephone survey was conducted to determine if the data has changed over time and to find out patients understanding of glycosylated hemoglobin. Analysis was done using SPSS version 22.0. Results: The study summarizes data about 526 patients with 1TCD. The average age is 39.9 years (+/- 15). Average 1TCD duration 15.9 years (+/- 13). The mean HbA1C is 9.5% (+/- 2). 78% of patients knew what glycosylated hemoglobin is and 88% of them measured 4x / year. 68% of patients had normal BMI. 35.9% had a history of at least one of the cardiovascular diseases. The most frequent of the microvascular complication of the CD was polyneuropathy (56%), the second most commonly was retinopathy (37%), the less common was nephropathy (23.6%). 13 patients had foot ulcers and 13 patients had lower limb amputation. A statistically significant correlation was found between the duration of diabetes, metabolic compensation and DPN incidence. Conclusions: The incidence of diabetic polyneuropathy and amputation is more common in patients with higher age, duration of diabetes and poorly controlled blood glucose. Polyneuropathy develops as the first microvascular complication of diabetes, but most patients with diabetes and lower limb amputations also had diabetic retinopathy and nephropathy. Atherosclerosis increases the risk of developing diabetic foot.
Description
Keywords
Medicīna , 1.tipa cukura diabēta , diabēta polineiropātija , diabēta pēda , diabēta pēdas čūla , apakšējās ekstremitātes amputācija