Avaliação de neuropatia e vasculopatia em portadores de diabetes

Abstract

Background: To evaluate vasculopathy and neuropathy in diabetic patients in the secondary attention centres of public health system in Sergipe, from February 2012 to July 2013, by scrutinising samples and risk variables to the development of diabetic foot. Methods: 79 diabetic patients were evaluated by a descriptive and observational study according to the clinical protocol from the National Census of Diabetic Foot. For such work, were used questionnaires followed by physical exams which included the calculation of the ankle-brachial index (ABI) with the use of Eco Doppler exam to the analysis of the vasculopathy; and the nylon monofilament test, the scores of neuropathic symptoms and disabilities to the evaluation of the neuropathy. Besides, an investigation on the risk factors associated to the processes of peripheral neuropathy and ischemia was made. Results: Between the patients studed, the majority was diabetes mellitus type 2 (86%). Although 6,3% of patients had related previous ulcera on their feet, only 1,3%were submitted to amputation. With respect to the foot classification, 60,8% had normal feet, while 20,3% had neuropathic feet, 10,1% had ischemic feet and 8,9% had neuroischemic feet. The risk of developing neuropathic diabetes amounts to 83,5% of patients. Concerning the (ABI), 19% of patients had some degree of peripheral vasculopathy. Conclusion: most of patients have neuropathic risc, with neuropathic signs/symptoms, though without any disability. However, the neuropathic feet predominate over the ischemic and neuro-ischemic ones, confirming the discrete variation of ABI. The majority of patients neither suffer from ulcera nor had amputation, although their feet risked being cut off.