Duration of Hospital Treatment of Patients with Diabetes Mellitus Type 2 and Diabetic Foot Syndrome Depending on Compensation of Carbohydrate Metabolism
Journal Title: Міжнародний ендокринологічний журнал - Year 2014, Vol 4, Issue 60
Abstract
Aim of the Study. To investigate the effect of type 2 diabetes mellitus (DM) compensation on the duration of inpatient treatment of patients with neuroischemic diabetic foot syndrome (DFS). Materials and Methods of the Study. We examined 363 patients (164 men and 199 women), who were treated in surgical hospital for neuroischemic DFS. The diagnosis was established by studying peripheral sensitivity and assessment of blood flow in the lower extremities. The survey of patients was conducted with NSS (Neurological symptoms score) and TSS (Total symptoms score). Tactile sensitivity was determined using monofilament (Semmens-Weinstein), standardized by 10 g/cm2 pressure, pain — neurological needle Neuropen, temperature — using Tip-term thermal cylinder, vibration — a graduated tuning-fork Riedel Seifert, 128 Hz. Compensation of DM was evaluated according to glycated hemoglobin (HbA1c) content. Treatment of patients was carried out according to national treatment protocols for DFS taling into account guidelines of International Working Group on the Diabetic Foot (IWGDF). Results of the Study. Lancing of abscess and phlegmons was done in 60 % of women and 40 % of men, amputations of different levels — in 20 % of women and 40 % of men. Age of men to whom amputation was conducted was over 66 years, women — over 70 years. Duration of peri- and postoperative treatment depended on the degree of carbohydrate metabolism compensation in patients. Conclusions. Duration of hospitalisation of patients with neuroischemic DFS in HbA1c level 12.6 ± 1.2 % was 16.60 ± 0.26 days for men and 18.95 ± 0.51 — for women. With average HbA1c level 15.5 ± 1.0 % the duration of hospital stay was 34.66 ± 0.40 days and 31.42 ± 1.18 days, respectively. Best healing of surgical wounds was observed at average daily glycemia no more than 10 mmol/l.
Authors and Affiliations
B. G. Bezrodny, M. O. Prystupyuk, L. D. Martynovych
Keywords
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