Endocrine Abstracts

Introduction: Diabetic foot syndrome is a common surgical pathology. It is the main cause of lower limb amputations, which can be avoided in 85% of cases by active detection and long-term compensation of T2DM, timely diagnostics of peripheral neuropathy.

Purpose: To study relation between compensation of diabetes (by HbA1c) and time needed for healing of ulcers and purulent processes in patients with neuroischaemic forms of diabetic foot.

Results: The results of treatment of 363 patients were worked out: 164 males (45%) and 199 females (55%), the average age of men 65±0.20 years, women 70±0.22 years (P<0.001). By admission, patients had been treated by oral hypoglycaemic medicines in combinations of up to three drugs at the time with maximum permissible doses. In hospital all subjects were treated with insulin. The most common surgery was opening of abscesses and phlegmons in 40% of males and 60% of females. Amputations of lower limbs and phalanges were performed in 40% of men (over 66 years) and 20% of women (over 70 years). In terms of post-prandial glycaemia, compensation of diabetes was achieved in 22% of males and 32% of females, stay period in hospital of whom was the lowest.

Conclusions: i) With HbA1c 15.5±1.0%, duration of treatment of neuroischaemic forms of diabetic foot lasted 34.66±0.40 days for males and 31.42±1.18 days for females, while with HbA1c 12.6±1.2% it lasted 16.60±0.26 and 18.95±0.51 days respectively. ii) Fasting glycaemia up to 6 mmol/l and post-prandial glycaemia up to 10 mmol/l are the best values for enhancing reparative processes in patients and shortening their hospital stay. iii) Among patients with uncompensated diabetes, number of limb amputations is so high that this should motivate patients for conducting adequate treatment and self-control of diabetes.