Resumen

Introduction: Diabetes mellitus (DM) can present complications of neuropathy and peripheral arterial disease with high risk for developing foot ulcers and consequent amputations. Objective: To identify the association between peripheral vascular disease and neuropathy in type 2 diabetes mellitus patients from the Hospital General de Zona No. 1 IMSS in Colima. Material and methods: A cross-sectional study of 80 patients with diabetes mellitus evaluated by means of the Edinburgh Claudication Questionnaire, Michigan Neuropathy Screening Instrument, ankle-brachial index, motor nerve conduction study, and H-reflex was carried out. Results: Fifty-one women and 29 men were studied. Mean age was 53.9 ± 9.6 years, mean length of time with diabetes mellitus was 8 ± 6.6 years, and mean fasting glucose was 283 ± 110 mg/mL. Neuropathy presented in 65 patients (81.2%). Ankle-brachial index showed moderate peripheral vascular disease in 19% of patients. Motor nerve conduction study was abnormal in 40% of patients and H-reflex was absent in 70%. Logistic regression analysis showed no significant association between vascular damage and neuropathy. However, high glucose levels (OR = 4.09, 95% CI = 2.04-11.78) and history of high blood pressure and heart disease (OR = 4.85, 95%CI = 1.27- 18.48) were independent predictive variables for neuropathy risk. Discussion: It can thus be inferred that the complication of diabetic neuropathy appears before peripheral vessel damage and that when the diabetic patient seeks medical attention for a problem of peripheral vascular disease beyond claudication, he or she would already have an advanced degree of neuropathy with greater complications and minimal possibilities of recovery.

Palabras clave: Diabetic neuropathy peripheral vascular disease and type 2 diabetes mellitus ABI in diabetes. H-reflex diabetic neuropathy prevalence Mexico.

2014-11-07   |   528 visitas   |   Evalua este artículo 0 valoraciones

Vol. 63 Núm.6. Noviembre-Diciembre 2011 Pags. 621-629 Rev Invest Clin 2011; 63(6-ENGLISH)