Tork H. M, Tajbakhsh F. A Survey of the Presence of Lower Limb Arterial Insufficiency in Diabetic Patients Attending the Surgery Department of Golestan Hospital for Reasons other than Vascular Diseases. Biomed Pharmacol J 2015;8(2)

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Hussein Minai Tork^1* and Fatemeh Tajbakhsh²

¹Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ²School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

DOI : https://dx.doi.org/10.13005/bpj/877

Abstract

Diabetic ulcer is the commonest reason of lower limb amputation. When atherosclerosis progressed, lower limb ischemia occurred. We also know diabetes is one of the effective risk factors in atherosclerosis, for this reason lower limb ischemia is one of the commonest long term complications of diabetes. Chronic lower limb ischemia could be asymptomatic or occur with intermittent claudication with pain and cramp in legs muscles. Pain begins with activity and relieves with rest. First, ischemia associated with intermittent claudication and then painful ulcerith gangrene was observed. The other symptoms such as muscles atrophy, cutaneous atrophy, hair loss on dorsal surface of fingers, and increase in the thickness of toenails are associated to chronic ischemia. This study was conducted on diabetic patients admitted to the surgery department for reasons other than vascular diseases. We designed the Pro forma to record the patients’ history including personal information, duration of suffering from diabetes. In addition, the symptoms of arterial insufficiency such as intermittent claudication, atrophic changes, cutaneous atrophy, muscles atrophy, hair loss on dorsal surface of fingers and increased thickness of toenails as well as pulse status other physical examinations were performed. The collected data were analyzed with SPSS package. Our study conducted on 120 diabetic patients that 52 (43.3%) patients were men. And 68 (56.7%) patients were women. Mean age in men and women had been 60.8 ±10, 56.8± 8.8. Based on our results 26 (21.7%) patients arterial pulse was not palpated and in 41 (34.2%) patients we found weak arterial pulses and in 53 patients (44.2%) arterial pulses were normal. Variance analysis test showed that the mean of the duration of suffering from diabetes had significant difference in these three groups (P= 0.018). In other tests, pallor was observed in 49.2% of patients. Intermittent claudicating was found in 32.5%of patients and impaired capillary filling test were seen in 60% of patients. Results of the rubor of dependency test were positive in 43.5% of patients and venous filling time test in 60% of patients was abnormal. And in 65% of patients coldness of extremities was positive. Our findings showed that the performed clinical tests facilitate the diagnosis of ischemia and therefore it seems necessary to perform these tests for all diabetic patients especially when admitted for surgery operation.

Keywords

Ischemia, Diabetes; Arterial Pulse; Lower Limb; Arterial Insufficiency