ارزيابي وضعيت عصبي و عروقي پا در بيماران ديابتي مراجعه كننده به درمانگاه ديابت بيمارستان دكتر شريعتي در سال 83-1382

EVALUATION OF FOOT NEUROVASCULAR STATUS IN DIABETIC PATIENTS REFERRED TO DIABETES CLINIC OF DR. SHARIATI HOSPITAL, 2003-2004

Background: Foot complications are among the important problems of diabetic patients. Vascular and neurological involvements are two major causes for such complications. Methods: We studied 142 diabetic outpatients referred to diabetes clinic of Dr.Shariati Hospital from Dec. 2003 to Sep. 2004. We performed different neurological and vascular tests to assess the diabetic foot and data were analyzed by SPSS software. Results: 54.9% of the cases reached the symptom score of 5 and upper so they had neuropathy regarding the Michigan Neuropathy Disability Score (MNDS). By analyzing the overall symptom and sign scores, 61% had neuropathy. Regarding MNDS, 42.7% of the subjects were neuropathic. Finally 23.9% were unable to sense at least one point from 12 points of rnonofilament examination. 16.9% of the patients had the complaint of intermittent claudication, in 8.8% at least one of the peripheral pulses was not palpable, whereas 10.6% had some degree of PAD regarding to ABI and toe pressure. Conclusion: Using a monofilament is the most reliable method for screening of the neuropathy in diabetic patients. On the other hand, relying on symptoms like intermittent claudication and physical examination in order to find peripheral arterial disease in diabetic patients may lead to miss many cases, thus, performing some more precise diagnostic tests, such as ABI and toe pressure are highly recommended and reliable.