Background:
@EN The development of ulceration of the feet in patients with diabetes mellitus is an important cause of disability. Its etiology includes vascular disease, peripheral somatic sensory and motor and autonomic neuropathy. The aim of the present
study
was to assess the importance of neuropathy in the development and outcome of foot lesions in diabetics patients.
@ES Method:
@EN Somatic and autonomic functions were studied in three groups of diabetic patients:: Group I; 20 patients without neuropathy (neuropathic deficit score 0). Group II; 20 patients with neuropathy, but no foot lesion (neuropathic deficit
score>1).
Group
III; 20 patients with foot lesion.
We perform conduction studies on motor and sensory fibers of median, peroneal and sural nerves. For evaluating autonomic dysfunction, we test pupillary size and pupill cycle time to light, and also measure heart rate response to Valsalva
maneuver,
heart
rate variation during deep breathing, immediate heart rate response to standing and blood pressure responses to standing and sustained handgrip. To evaluate whether neuropathy may predict the outcome of diabetic foot lesions lesions were
characterized
by the same physician during the study.
@ES Result:
@EN 1) Patients with foot lesion showed evidence of more severe comatic and autonomic neuropathy than diabetic patients without foot lesion. Neuropathic patients with foot lesion showed markdly abnomral findings in the nerve conduction studies.
2) Among the tests. Peroneal motor and sural nerve conduction velocities and sural nerve potential amplitude of patients with foot lesion were significantly decreased than those of patients with neuropathy but without foot lesion (p<0.05).
3) Heart rate responses to Valsalva maneuver were significantly less in patients with foot lesion compaired with patients with neuropathy but without foot lesion (p<0.05). Autonomic score and pupil cycle time were significantly increased in
patients
with foot lesion compaired with patients with neuropathy but without foot lesion (p<0.05).
4) This study suggest that foot lesions does not usually develop in the absence of neuropathy. In addition, neuropathy in diabetic patients with foot lesions is of no value in predicting primary healing p>0.05).
@ES Conclusion:
@EN Neuropathy is one of important risk factor for inducing foot lesions in diabetic patients. Diabetic patients with abnormal nerve function should be given regular foot care to prevent the development of foot lesion.
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