Abstract:
Introduction. Neuropathy is the most common long-term complication of diabetes, which
affects about 50% of patients. The distal symmetric neuropathy that appears in 75% cases of
diabetic neuropathy is one of the main risk factors for developing diabetic foot ulcer. Besides
this, there are other important risk factors that could influence the development and the evolution
of tisular lesion in a diabetic foot.
Aim of the study. Determination of the risk factors and the severity degree of distal neuropathy
in patients with diabetic foot ulcers.
Materials and methods. Twenty-three patients with neuropathic form of the diabetic foot that
had trophic ulcer were included. A number of potential risk factors like the duration of diabetes
mellitus, use of insulin therapy, degree of distal neuropathy, poor glycemic control confirmed by
HbA1C level, presence of foot deformities, arterial hypertension, and BMI were evaluated. The
degree of distal neuropathy was assessed by clinical neuropathy scores: Neuropathy Symptoms
Score (NSS) and Neuropathy Disability Score (NDS).
Results. The duration of diabetes was more than 5 years in all patients, and 19 patients used
insulin. In 94.1% cases NSS was 7-9 points and NDS was 8-10 points that denotes severe
neuropathic symptoms. A total of 82.3% patients had poor glycemic control with a level of
HbA1C > 8%. 70.5% of patients had foot deformities and in 76.4% cases arterial hypertension
was recorded. 94.1% had a BMI > 25 kg/m2, 35.3% were overweight and 58.8% had obesity.
Conclusion. Development and progression of trophic ulcers in patients with neuropathic diabetic
foot are determined by the distal neuropathy severity degree and are associated with long term
diabetes and requirement in insulin therapy. Poor glycemic control, foot deformities, arterial
hypertension, overweight and obesity are the risk factors that should be corrected for prophylaxis
and successful treatment of skin lesions in patients with diabetic foot.
