Faculty of Medicine
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Item type:Publication, IMPACT OF METABOLIC CONTROL IN PREULCERATIVE PHASE OF DIABETIC FOOT(SHMSHM / AAMD, 2011-06); ; Aim. To estimate impact of metabolic disturbances in type 2 diabetic patients (T2DM) and risk for ulceration in preulcerative phase of diabetic foot syndrome (DFS). Material and methods. In this prospective study following parameters are estimated: duration, smoking, BMI, BP, HbA1c, TG, HDL, LDL, fundoscopy and measurements for risk score of DFS. Groups were stratified according measurements : 0–low risk, 1–medium risk, 2-high risk, and 3–very high risk. Results. From 100 patients, 53% were female and 47% male. Mean duration of T2DM 10, 47 ±4, 77 year. Smokers are registered to have 43%, Results of measurements for risk score stratifications have been in V1: score 0-29 %, 1–3%, 2-18% and 3–18% and in V2 in score 0-17 %, 1–39%, 2-19% and 3–25%. BMI was recorded as follows: normal (18-25 kg/m2) 14%, overweighed (25-30 kg/m2) 71% and obese (>30 kg/m2) 15%. Mean HbA1c in V1 was recorded: 0-7,6%, 1-7,9%, 2-8,5% and 3-8,2% (p<0,005), and in V2: score 0-7.26%, 1-7.46%, 2-7, 54% and 3-7, 54%. Systolic BP divided regarding scores is measured: score 0–136 mmHg, 1–142 mmHg, 2–145 mmHg, 3–142 mmHg. Mean levels of TG were: 0-1,97 mmol/L, 1-2,37 mmol/L, 2-2,3 mmol/L, 3-2,6 mmol/L. Mean levels of HDL: 0–1,06 mmol/L, 1–1,02 mmol/L, 2–0.97 mmol/L, 3–1,00 mmol/L. Mean levels of LDL: 0–3,69 mmol/L, 1–4,27 mmol/L, 2–4,05 mmol/L 3–4,09 mmol/L. Conclusion: Bad management of T2DM have impact in early appearance of DFS and early progression from low to high score for foot ulceration. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Diabetic foot with risk for ulceration associated with diabetic retinopathy in type 2 diabetes(European Society of Endocrinology, 2011); ; Katerina AdamovaAim: To define impact of diabetic retinopathy as a risk factor at peoples with type 2 diabetes and diabetic foot. Material and methods: One hundred hospitalized patients with type 2 diabetes, screened for diabetic foot and diabetic retinopathy for 1 year. Clinical examination and laboratory investigations were evaluated. Results: From 100 patients, 53% were female and 47% male, duration of diabetes 10.47±4.77 years. Mean HbA1c was 8%±1.2%. HbA1c<7% had 18%, HbA1c 7–8% had 43% and HbA1c >8% had 49% of patients. At visit 1, risk score for diabetic foot ulceration is: low risk (0) 29%, medium risk (1) 35%, high risk (2) 18% and very high risk (3) 18%). Retinopathy was present with 68% – 53% non prolypherative and 15% prolypherative. According the risk score at visit 1 retinopathy had: in score 0 – 15% non-prolipherative and 0% prolipherative, score 1 – 18% non-prolypherative and 1% prolypherative, score 2 – 11% non-prolypherative and 6% prolypherative, and score 3 – 9% non-prolypherative and 8% prolypherative. After 12 months risk score for diabetic foot was: 0 – 17%; 1 – 39%; 2 – 19% and 3 – 27%. Diabetic retinopathy was present after 12 months 72% of which 51% non-prolypherative and 21% prolypherative. According the risk score after 1 year diabetic retinopathy were present: in score 0 – 6% non-prolyherative and 0% prolypherative, score 1 – 22% non-prolypherative and 3% prolypherative, score 2 – 10% non-prolypherative and 7% prolypherative, and score 3 – 13% non-prolypherative and 11% prolypherative. Conclusion: Association between risk score for foot ulceration and diabetic retinopathy was present. Group with risk score 0 and 1 have more non-prolypherative retinopathy and group with score 2 and 3 have more prolypherative retinopathy (Cross tabulation. Kruskal Wallis test P<0.01).