Riesgo de pie diabético en pacientes con diabetes mellitus tipo 2 en una unidad de medicina de familia / Diabetic foot risk in patients with type II diabetes mellitus in a family medicine unit

Objetivo: Conocer el riesgo para desarrollar pie diabético en pacientes con diabetes mellitus (DM) tipo 2 (DM2). Métodos: Se incluyeron pacientes con DM2 con una evolución ≥ 5 a˜nos que acudieron a la consulta externa en una Unidad de Medicina Familiar en Tijuana (México) durante septiembre a diciembre de 2011. Se aplicó el cuestionario síntomas de neuropatía diabética (SND) y se evaluó la sensibilidad con el monofilamento de Semmes-Weinstein. Se consideró paciente de alto riesgo para pie diabético si tuvo pérdida de la sensibilidad, deformidad en pies o ausencia de pulsos pedios. Resultados: Se estudiaron 205 pacientes, con una edad y evolución de la DM promedio (± DE) de 59 ± 10 y 10,7 ± 6,7 a˜nos, respectivamente. Noventa y un pacientes (44%) tuvieron alto riesgo para desarrollar pie diabético, y este se asoció con escolaridad menor de 6 a˜nos (OR: 2,3; IC 95%: 1,1-4,1), evolución de la DM mayor a 10 a˜nos (OR: 5,1; IC 95%: 2,8-9,4), sexo femenino (OR: 2,0; IC 95%: 1,1-3,6), ingreso mensual familiar < 236 euros (OR: 2,0; IC 95%: 1,1-3,8) y una hemoglobina glucosilada (HbA1c) ≥ 7,0% (OR: 2,8; IC 95%: 1,5-5,0). Conclusiones: Es necesario que a todo paciente con DM que acude a su clínica familiar se le realice anualmente exploración para la detección temprana de neuropatía diabética debido al alto riesgo de desarrollo de pie diabético (AU)

Objective: To determine the risk of diabetic foot in patients with type II diabetes mellitus (DM) seen in a Family Medicine Unit. Methods: The study included type II DM patients with a disease duration ≥ 5 years seen in a Family Medicine Unit, Tijuana, Mexico, during September-December 2011. Neuropathy was assessed with the Diabetic Neuropathy Symptom questionnaire, and pressure sensation using a 10-g Semmes-Weinstein monofilament. A patient had a high risk of diabetic foot if there was sensitivity loss, foot deformities, and non-palpable pedal pulses. Results: We studied 205 patients with an average (± SD) age and DM duration of 59 ± 10 years and 10.7 ± 6.7 years, respectively. Ninety one patients (44%) had a high risk of developing diabetic foot, and it was associated with; an education of less than 6 years (OR 2.3; 95% CI: 1-1-4.1), DM disease duration ≥ 10 years (OR 5.1; 95% CI: 2.8-9.4), female gender (OR 2.0; 95% CI: 1.1-3.6), monthly familiar income < 236 euros (OR 2.0; 95% CI: 1.1-3.8), and a glycosylated hemoglobin ≥ 7.0% (OR 2.8; 95% CI: 1.5-5.0). Conclusions: It is necessary that all DM patients seen in a family medicine clinic have a yearly screening for the early detection of diabetic neuropathy, since they have a high risk of diabetic foot (AU)

[Diabetic foot risk in patients with type II diabetes mellitus in a family medicine unit]. / Riesgo de pie diabético en pacientes con diabetes mellitus tipo2 en una unidad de medicina de familia.

OBJECTIVE: To determine the risk of diabetic foot in patients with type II diabetes mellitus (DM) seen in a Family Medicine Unit. METHODS: The study included type II DM patients with a disease duration ≥ 5 years seen in a Family Medicine Unit, Tijuana, Mexico, during September-December 2011. Neuropathy was assessed with the Diabetic Neuropathy Symptom questionnaire, and pressure sensation using a 10-g Semmes-Weinstein monofilament. A patient had a high risk of diabetic foot if there was sensitivity loss, foot deformities, and non-palpable pedal pulses. RESULTS: We studied 205 patients with an average (± SD) age and DM duration of 59 ± 10 years and 10.7 ± 6.7 years, respectively. Ninety one patients (44%) had a high risk of developing diabetic foot, and it was associated with; an education of less than 6 years (OR 2.3; 95%CI: 1-1-4.1), DM disease duration ≥ 10 years (OR 5.1; 95%CI: 2.8-9.4), female gender (OR 2.0; 95%CI: 1.1-3.6), monthly familiar income <236 euros (OR 2.0; 95%CI: 1.1-3.8), and a glycosylated hemoglobin ≥ 7.0% (OR 2.8; 95%CI: 1.5-5.0). CONCLUSIONS: It is necessary that all DM patients seen in a family medicine clinic have a yearly screening for the early detection of diabetic neuropathy, since they have a high risk of diabetic foot.