[Non-invasive diagnosis of angiopathies and neuropathies in screening for the diabetic foot syndrome].

As part of screening focused on the incidence and risk of the diabetic foot syndrome in patients in a model area the authors compared values of different parameters of non-invasive examination methods of angiopathy and neuropathy in patients with diabetic foot and in diabetic patients without diabetic foot. They compared the data with normal clinical diagnosis and used them to assess the degree of risk of diabetic foot. Patients with diabetic foot had when examined for the threshold of vibration perception (VPT) by a biothesiometer, as compared with patients without diabetic foot, significantly higher VPT levels 361 +/- 16 vs. 25 +/- 12 V, p < 0.001. For assessment of a high risk of diabetc foot in this age group of diabetics it proved useful to use as a critical VPT level, values above 30 V. During the non-invasive diagnosis of angiopathy in the group with diabetic foot a significantly lower ratio of systolic pressures ankle/arm (0.82 +/- 0.43 vs. 0.92 +/- 0.26, p < 0.05) was found. The critical value for high risk of diabetic foot is the ratio 0.8. Both non-invasive methods make current clinical diagnosis markedly more accurate when assessing the risk of diabetic foot. Patients with diabetic foot had, as compared with other diabetics, a poorer compensation of diabetes (HbA1c 8.6 +/- 2 vs. 8.0 +/- 1.5%, p < 0.05) and poorer renal functions (creatinine 114 +/- 57 vs. 94 +/- 25 umol/l, p < 0.01), the cholesterol and triacyglycerol levels were higher in both groups, however they did not differ significantly.