Comparative characteristics of Limb Rescue Center patients with diabetic foot syndrome and type 1 and type 2 diabetes mellitus

Diabetic foot syndrome (DFS) is a significant medical and social problem. Despite modern prevention and treatment options, as well as patient routing, DFS remains one of the dominant causes of lower limb amputation and leads to disability in patients with both type 1 (DM1) and type 2 (DM2) diabetes mellitus.

The aim. To compare the clinical and laboratory characteristics of patients with DM1 (n = 30) and DM2 (n = 729) hospitalized at the Limb Rescue Center of the V.P. Demikhov State Clinical Hospital in the period from 2019 to 2020.

Materials and methods. Anamnestic and clinical laboratory data from 759 electronic medical records of patients of the limb rescue center, patients with DM1 or DM2, were analyzed.

Results. The majority of patients with DM1 were 45–60 years old – 56.67% (n = 17), with DM2 – elderly (50.75%, n = 370). The median fasting plasma glucose upon admission in patients with DM1 was 11.5 [6.2; 14.7] mmol/L, in patients with DM2 – 9.9 [7.2; 13.8] mmol/L. The average HbA1c in group 1 was 8.71 ± 0.26 (95% CI: 8.18 – 9.25 in patients with DM2 – 7.8 [6.7; 9.1]%. The mean GFR was 65.92 ± 3.43 (95% CI: 58.88 – 60.57) ml/min/1.73 m² and 63.38 ± 0.90 (95% CI: 61.62 – 65.15) ml/min/1.73 m², respectively, in groups 1 and 2. The structure of ulcerative necrotic lesions in patients with DM1 was dominated by ulcer (33.33%, n = 10) and purulent/purulent-destructive arthritis (26.6%, n = 8), and in patients with DM2 - gangrene (33.47%, n = 244) and ulcer (25.1%, n = 183). Amputation occurred in 36.67% (n = 11) of patients with DM1 and in 24.3% (n = 372) of patients with DM2.

Conclusions. The identified features of patients with DFS and DM1 and DM2, along with the data obtained on the relatively high frequency of amputations in both groups, indicate the need to optimize patient routing algorithms and increase the attention of patients with both DM1 and DM2 to the importance of foot care and regular visits to the diabetic foot office.

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