Gulcan Aynur, Gulcan Erim, Oksuz Sukru, Sahin Idris, Kaya Demet
Department of Microbiology and Clinical Microbiology, Erzurum Region Education and Research Hospital, Erzurum, Turkey.
J Am Podiatr Med Assoc. 2011 Jan-Feb;101(1):49-54. doi: 10.7547/1010049.
we sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors.
data regarding patients' diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients' toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture.
of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A(1c) and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts.
long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus.
我们试图确定糖尿病患者趾甲甲癣的发病率，识别致病因子，并评估流行病学风险因素。
主治内科医生记录患者的糖尿病特征数据。皮肤科医生对患者的趾甲进行临床检查，并从趾甲采集标本以确定甲癣异常情况。所有标本均进行直接显微镜检查和培养。
在321例2型糖尿病患者中，162例被诊断为临床甲癣；其中41例诊断经真菌学证实。分离出的真菌中，23例为酵母菌，18例为皮肤癣菌。发现甲癣发病率与视网膜病变、神经病变、肥胖、家族史及糖尿病病程之间存在显著相关性。然而，未发现与性别、年龄、教育程度、职业、居住地区、糖化血红蛋白A（1c）水平及空腹血糖水平以及肾病存在相关性。临床标本中最常分离出的病原体是酵母菌。
长期控制血糖以预防慢性并发症和肥胖，并促进关于足部和趾甲护理重要性的教育，应成为预防糖尿病患者甲癣及其潜在并发症（如继发性足部病变）的重要组成部分。
