Assessment of ulceration risk in diabetic individuals

ABSTRACT Objective: To identify the risk factors for foot ulceration through the tracing of diabetic peripheral neuropathy and peripheral arterial disease in individuals with type I and II diabetes, who were assisted in reference centers of the Federal District, Brazil. Method: a cross-sectional and analytical study, with the assessment of 117 individuals in outpatient clinics of the Federal District. Continuous variables were compared through Mann-Whitney test, and categorized variables, through Chi-square test for univariate analysis and Logistics regression test for multivariate analysis. Results: painful diabetic peripheral neuropathy was present in 37 (75.5%) of the individuals with neuropathy. Deformities and loss of protective plant sensibility were related to neuropathy (p=0.014 and p=0.001, respectively). Of the 40 (34.2%) individuals in the sample who presented peripheral arterial disease, 26 (65%) presented calcification risk. Conclusion: signs of painful peripheral polyneuropathy, peripheral arterial disease, deformities, loss of protective plantar sensibility, and dry skin were identified as risk factors for ulceration.

摘要
目的：通过追踪巴西联邦特区转诊中心收治的I型、II型糖尿病患者的糖尿病周围神经病变与外周动脉疾病发病情况，明确足溃疡的危险因素。
方法：本研究为横断面分析研究，共纳入巴西联邦特区门诊收治的117例患者开展评估。连续变量采用曼-惠特尼检验（Mann-Whitney test）进行组间比较，分类变量则分别采用卡方检验（Chi-square test）完成单因素分析（univariate analysis）、Logistic回归（Logistic regression）分析完成多因素分析（multivariate analysis）。
结果：合并神经病变的患者中，37例（75.5%）存在痛性糖尿病周围神经病变（painful diabetic peripheral neuropathy）。足部畸形与保护性足底感觉丧失与神经病变显著相关（分别对应p=0.014、p=0.001）。本研究样本中，40例（34.2%）患者存在外周动脉疾病，其中26例（65%）存在钙化风险。
结论：痛性周围多发性神经病变、外周动脉疾病、足部畸形、保护性足底感觉丧失以及皮肤干燥，被证实为足溃疡的危险因素。