Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot Ulcers
<i>Background and Objectives</i>: According to the International Working Group on Diabetic Foot (IWGDF) risk classification, the estimated risk of developing a diabetic foot ulcer (DFU) is much higher in patients with a history of DFUs (Grade 3) compared to those with a peripheral neurop...
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MDPI AG
2024-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/61/1/2 |
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| author | Julien Vouillarmet Audrey Josset-Lamaugarny Myriam Moret Christine Cugnet-Anceau Paul Michon Emmanuel Disse Dominique Sigaudo-Roussel |
| author_facet | Julien Vouillarmet Audrey Josset-Lamaugarny Myriam Moret Christine Cugnet-Anceau Paul Michon Emmanuel Disse Dominique Sigaudo-Roussel |
| author_sort | Julien Vouillarmet |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: According to the International Working Group on Diabetic Foot (IWGDF) risk classification, the estimated risk of developing a diabetic foot ulcer (DFU) is much higher in patients with a history of DFUs (Grade 3) compared to those with a peripheral neuropathy but without a history of DFUs (Grades 1 and 2). It has been suggested that microcirculation impairment is involved in DFU genesis and could be taken into account to refine the existing risk classification. The aim of this study was to evaluate microcirculation parameters in patients with diabetes according to their estimated DFU risk. <i>Materials and Methods:</i> A total of 172 patients with type 2 diabetes associated with a peripheral neuropathy and/or a history of DFUs were included and classified into two groups (Grade 1–2 and Grade 3) according to the IWGDF classification. All patients underwent an evaluation of peripheral neuropathy, plantar sudomotor function, and skin microcirculation parameters. These different parameters were compared between both groups. <i>Results</i>: There was no significant difference between the two groups in terms of age, diabetes duration, transcutaneous oxygen pressure level, skin microcirculatory reactivity, neuropathy disability score, neuropathy symptom score, or thermal sensitivity. Patients in Grade 3 were more likely to present with retinopathy (OR 3.15, 95%CI [1.53; 6.49]) and severe sudomotor dysfunction (OR 2.73 95%CI [1.29; 5.80] but less likely to have abnormal VPT (OR 0.20 95%CI [0.05; 0.80]). <i>Conclusions</i>: The present study found more retinopathy and a more pronounced alteration to sudomotor function in Grade 3 patients, suggesting that these parameters could be considered to better identify patients at high risk of DFUs. |
| format | Article |
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| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-2165cd4b12314387b545e6cd41c627742025-01-24T13:40:12ZengMDPI AGMedicina1010-660X1648-91442024-12-01611210.3390/medicina61010002Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot UlcersJulien Vouillarmet0Audrey Josset-Lamaugarny1Myriam Moret2Christine Cugnet-Anceau3Paul Michon4Emmanuel Disse5Dominique Sigaudo-Roussel6Service d’Endocrinologie, Diabète et Nutrition, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, FranceLaboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, CNRS UMR 5305, 69367 Lyon, FranceService d’Endocrinologie, Diabète et Métabolisme, Groupement Hospitalier Est, Hospices Civils de Lyon, 69677 Bron, FranceService d’Endocrinologie, Diabète et Nutrition, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, FranceService d’Endocrinologie, Diabète et Nutrition, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, FranceService d’Endocrinologie, Diabète et Nutrition, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, FranceLaboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, CNRS UMR 5305, 69367 Lyon, France<i>Background and Objectives</i>: According to the International Working Group on Diabetic Foot (IWGDF) risk classification, the estimated risk of developing a diabetic foot ulcer (DFU) is much higher in patients with a history of DFUs (Grade 3) compared to those with a peripheral neuropathy but without a history of DFUs (Grades 1 and 2). It has been suggested that microcirculation impairment is involved in DFU genesis and could be taken into account to refine the existing risk classification. The aim of this study was to evaluate microcirculation parameters in patients with diabetes according to their estimated DFU risk. <i>Materials and Methods:</i> A total of 172 patients with type 2 diabetes associated with a peripheral neuropathy and/or a history of DFUs were included and classified into two groups (Grade 1–2 and Grade 3) according to the IWGDF classification. All patients underwent an evaluation of peripheral neuropathy, plantar sudomotor function, and skin microcirculation parameters. These different parameters were compared between both groups. <i>Results</i>: There was no significant difference between the two groups in terms of age, diabetes duration, transcutaneous oxygen pressure level, skin microcirculatory reactivity, neuropathy disability score, neuropathy symptom score, or thermal sensitivity. Patients in Grade 3 were more likely to present with retinopathy (OR 3.15, 95%CI [1.53; 6.49]) and severe sudomotor dysfunction (OR 2.73 95%CI [1.29; 5.80] but less likely to have abnormal VPT (OR 0.20 95%CI [0.05; 0.80]). <i>Conclusions</i>: The present study found more retinopathy and a more pronounced alteration to sudomotor function in Grade 3 patients, suggesting that these parameters could be considered to better identify patients at high risk of DFUs.https://www.mdpi.com/1648-9144/61/1/2diabetic footneuropathysudomotor functionmicrocirculation |
| spellingShingle | Julien Vouillarmet Audrey Josset-Lamaugarny Myriam Moret Christine Cugnet-Anceau Paul Michon Emmanuel Disse Dominique Sigaudo-Roussel Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot Ulcers Medicina diabetic foot neuropathy sudomotor function microcirculation |
| title | Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot Ulcers |
| title_full | Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot Ulcers |
| title_fullStr | Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot Ulcers |
| title_full_unstemmed | Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot Ulcers |
| title_short | Impairment of Microcirculation Parameters in Patients with a History of Diabetic Foot Ulcers |
| title_sort | impairment of microcirculation parameters in patients with a history of diabetic foot ulcers |
| topic | diabetic foot neuropathy sudomotor function microcirculation |
| url | https://www.mdpi.com/1648-9144/61/1/2 |
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