[一家家庭医疗单位中II型糖尿病患者的糖尿病足风险]

[Diabetic foot risk in patients with type II diabetes mellitus in a family medicine unit].

作者信息

Márquez-Godínez S A, Zonana-Nacach A, Anzaldo-Campos M C, Muñoz-Martínez J A

机构信息

Unidad de Medicina Familiar N.(o) 27, Instituto Mexicano del Seguro Social, Tijuana, Baja California, México.

Unidad de Investigación Clínica y Epidemiológica, Hospital General Regional N.(o) 20, Instituto Mexicano del Seguro Social, Tijuana, Baja California, México.

出版信息

Semergen. 2014 May-Jun;40(4):183-8. doi: 10.1016/j.semerg.2013.10.004. Epub 2014 Feb 3.

DOI:10.1016/j.semerg.2013.10.004

PMID:24503170

Abstract

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.

摘要

目的

确定在家庭医学科就诊的2型糖尿病患者发生糖尿病足的风险。

方法

该研究纳入了2011年9月至12月期间在墨西哥蒂华纳的一个家庭医学科就诊、病程≥5年的2型糖尿病患者。使用糖尿病神经病变症状问卷评估神经病变，并使用10克Semmes-Weinstein单丝评估压力感觉。如果患者存在感觉丧失、足部畸形且足部脉搏触诊不清，则其发生糖尿病足的风险较高。

结果

我们研究了205例患者，其平均（±标准差）年龄和糖尿病病程分别为59±10岁和10.7±6.7年。91例患者（44%）发生糖尿病足的风险较高，且与以下因素相关：受教育年限少于6年（比值比2.3；95%置信区间：1.1-4.1）、糖尿病病程≥10年（比值比5.1；95%置信区间：2.8-9.4）、女性（比值比2.0；95%置信区间：1.1-3.6）、家庭月收入<236欧元（比值比2.0；95%置信区间：1.1-3.8）以及糖化血红蛋白≥7.0%（比值比2.8；95%置信区间：1.5-5.0）。