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Anales de la Facultad de Ciencias Médicas (Asunción)
Print version ISSN 1816-8949
Abstract
CANATA, María Gabriela et al. Risk factors associated with Loss of Protective Sensitivity in Diabetes patients in the Multidisciplinary Unit of Diabetic Foot. An. Fac. Cienc. Méd. (Asunción) [online]. 2021, vol.54, n.1, pp.61-66. ISSN 1816-8949. https://doi.org/10.18004/anales/2021.054.01.61.
Introduction:
Identifying risk factors for loss of protective sensitivity is essential to prevent Diabetic Foot.
Objectives:
To analyze the risk factors associated with the loss of protective sensitivity in patients with diabetes mellitus and its complications.
Materials and methods:
observational, case-control design. Patients of both sexes were included, with diabetes mellitus; ≥ 18 years, who underwent the Monofilament Test in the Multidisciplinary Unit Hospital de Clínicas, from January 2014 to July 2019. Risk factors considered: age, years of diabetes mellitus, Hba1c, HT, dyslipidemia; Complications were taken into account: retinopathy, peripheral arterial disease = ABI <0.9 right and left, kidney disease = CrCl <60 ml / min / m2 (MDRD), amputations (major and minor).
Results.
Of 100 patients; 33% with loss of protective sensitivity; age 59 ± 9.7 years; 55% male. Risk factors: age: 57.7 ± 1.0 years without loss of protective sensitivity and 61.2 ± 9 years with loss of protective sensitivity, p = 0.08; years of diabetes mellitus 9.4 ± 8.4 vs 11.5 ± 8.7 p = 0.20; HbA1C 8.8 ± 2.7% vs 9.1 ± 2% p = 0.50; HTN 63.5% vs 75.6% p = 0.20; dyslipidemias 75.9% vs 57.69%, p = 0.09; complications with loss of protective sensitivity: retinopathy 88% vs 57.5% OR = 1.67, p = 0.02. CrCl 84 ± 40.3 ml / min vs 90.9 ± 30.4, p = 0.40. Right peripheral arterial disease 27.78% vs 11.1% OR = 0.1, p = 0.10; left peripheral arterial disease 20% vs 7 15.5% OR = 1 p = 0.60; 17.5% amputation vs 7.9% OR = 2.01, p = 0.06.
Conclusion:
with loss of protective sensitivity: age, years of diabetes mellitus were older. HBP was more frequent and Hba1c higher; nephropathy, peripheral arterial disease and amputation with greater frequency, all not significant. Retinopathy was significantly more frequent.
Keywords : Diabetes mellitus; Loss of protective sensitivity; Monofilament test; Glycosylated hemoglobin; Retinopathy..