Peripheral vasculopathy in patients with diabetic foot in tertiary care hospital

Abstract

Diabetes mellitus(DM) is characterized by high blood sugar levels over a prolonged period due to alteration in either insulin secretion, insulin action, or both. Worldwide, as of the recent data collected from the World Health Organization (WHO) around 422 million adults have DM which is estimated to almost doubled by 2030 , mainly type 2 diabetes . The early detection of peripheral vascular disease in asymptomatic patients goes a long way in reduction of major and minor lower limb amputations and mortality. Hence, there is a need for evaluation of peripheral vascular disease (PVD) in all diabetics, especially those with diabetic foot by formulating effective management protocols, thereby limiting the morbidity, mortality and social costs associated with the disease. Methods: Patients who are admitted for diabetic foot ulcers between January 2017 and June 2018 in Department of General Surgery , ESIC MC & PGIMSR , Rajajinagar ,Bengaluru, India were taken for study. Results: 100 cases satisfying the inclusion criteria were taken up for the study from January 2017 to June 2018. Study population contains predominently( 68%) male patients . Out of 100 patients, 49 patients presented with pain as their most distressing symotom .Ankle brachial pressure index is less than 0.9 in 52 patiens and less than 0.3 in 06 patients. 62 Patients have documented abnormal blood flow in doppler study and CT angiogram due PVD. Most common site of block is femoropopliteal artery and collaterals are developed around the knee joint. Athersclerosis is the cause of PVD in 87% of patients.Conclusions: The prevalence of peripheral artery disease in patients with diabetic foot is significantly high i.e. 62 % as per this study. Males have a higher predilection for developing peripheral vascular disease than females. The average age of presentation of PAD in diabetics is 40 -60 years. The most common level of arterial occlusion in PAD associated diabetic foot is femoro-popliteal segment followed by tibial segment. Due to high prevalence of PVD mortality and morbidity is are significantly high these patients.