Diabetic foot syndrome in patients with diabetes type 1: patient’s image and clinical and laboratory characteristics

BACKGROUND. Diabetic foot syndrome (DFS) significantly worsens the quality of life of patients, and is also a significant economic problem for healthcare. Understanding the clinical and laboratory characteristics of patients with DFS and type 1 diabetes mellitus (DM1) may be the key to prevention and timely detection of complications.

PURPOSE. To study the clinical and laboratory characteristics of patients with DFS suffering from DM1.

MATERIALS AND METHODS. A retrospective analysis of 759 case histories of patients with diabetes mellitus of the Limb Rescue Center at the V.P. Demikhov State Clinical Hospital in the period from 2019 to 2020 was carried out. The object of the study was a group of patients with DM1 (n=30). The statistical analysis was carried out using the STATISTICA 8.0 program.

RESULTS. The average age of patients was 50.67±1.84 years (95% CI 46.89–54.44). 66.67% (n=20) of patients had a normal BMI, and the average BMI was 22.79±1.27 kg/m2 (95% CI 19.96–25.63). 86.7% had a long history of DM1. The median fasting plasma glucose was 13.1 mmol/l [7.1; 1.6]; and the average HbA1c was 8.71±0.26% (95% CI 8.18–9.25)). Almost half of the patients had microcytic anemia (47%, n=14). 66.67% (n=20) of patients already had a history of DFS. Hypertension was most common among the concomitant pathologies (50%, n=15) and atherosclerosis of the arteries of the lower extremities was almost as likely (46.67%, n=14). CHD (30%, n=9) and CKD (30%, n=9) were slightly less common among the studied patients as concomitant diseases. Only local treatment in the form of primary surgical treatment was provided mainly to patients with neuropatic form of DFS (46.67%, n=14). 10% (n=3) of patients underwent stenting, and 36.67% (n=11) underwent low amputation. The average duration of hospitalization was 11.55± 1.05 (95% CI 9.40–13.71) bed days.

CONCLUSION. Analysis of clinical and laboratory data showed that patients with DM 1 hospitalized at the limb rescue center had significant risk factors for the development of ulcerative necrotic pathology: decompensation of carbohydrate metabolism, dyslipidemia, arterial hypertension. Understanding the importance of correcting risk factors can prevent patients from developing pathology requiring surgical treatment, including amputation, which can help reduce the duration of hospitalization and, consequently, reduce the burden on healthcare in economic terms.

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