Endocrine Abstracts

Introduction: Diabetes promotes the development of arterial damage. Peripheral arterial disease is a classic localization of macroangiopathy, serious in its evolution; it constitutes a major risk factor for the occurrence of foot lesions in diabetics.

Goal of the Study: The aim of our study is to analyze the vascular profile of diabetic patients hospitalized for diabetic foot.

Patients and Methods: Descriptive retrospective study taking place over a period of 3 years, including 102 diabetics hospitalized in the endocrinology-diabetology department of the CHU Ibn Rochd for foot lesions.

Results: The average age of our patients was 57.5 years, with a clear male predominance of 62.7%, type 2 diabetes predominated in 85.2% of cases with a duration of evolution greater than 10 years in 74.5% and an average of HbA1c of 10%. The major risk factors for atherosclerosis found in our patients were dyslipidemia in 48% of cases, hypertension in 46%, obesity in 36.2%, smoking in 16.6% and physical inactivity in 60.7% of cases. Target organ damage was found in 56.8% of our patients, of whom 49% had diabetic retinopathy, 27.4% had diabetic nephropathy and 45% had peripheral neuropathy. 12.7% of our patients had a history of amputation. 68.6% of our patients were classified at very high cardiovascular risk. The foot lesions found were: MPP in 35% of cases, arteritic ulcer in 29.4% of cases, dermohypodermitis in 24.5% and osteitis in 23.5%. The ankle brachial index was pathological in 68.8% of patients, where 50% had an ABI <0.9 and 18.6% had an ABI >3. Doppler ultrasound objectified PAD in 88.2% of patients, arterial stenosis was found in 24.5% of cases where it was bilateral in 6.9%, atheromatous overload was present in 48.5% of patients and mediacalcosis in 15.9%. Doppler returned normal in 11.7% of patients. The evolution was marked by infection in 32.5% of patients and necrosis in 1.9% of patients. The mean healing time was 77 days.

Conclusion: The peripheral arterial disease is a serious complication of diabetes and the main factor of amputation. Prevention through the fight against cardiovascular risk factors is the basis of treatment.