Publication:

A study on peripheral neuropathy in patients with diabetic foot ulcers

Background Diabetic neuropathies are nerve disorders associated with diabetes. The most common complication of diabetes is caused by hyperglycemia which can damage nerve fibers throughout the body. Depending on the types of nerves involved, diabetic neuropathies can be categorized as peripheral, autonomic, proximal, focal neuropathies.

Methods A total of 62 diabetic foot patients admitted in general surgery department of Yenepoya medical college and hospital undergo neurological examination. Patients who were having peripheral neuropathy with diabetic foot ulcer between 18 and 85 years of age were included in the study.

Results On 62 patients with diabetic foot ulcers, 50 were unilateral and 12 were bilateral among which 8 patients had undergone toe amputation prior to examination. Patients were predominantly male 48 (77.4%). There were 14 women and 48 men with an average duration of diabetics being 15.6 and 14.8 years respectively. Women   were older than male patient (58.2 v/s 51.7 years). Study of motor and sensory signs men and women patients, abnormal deep tendon reflex and deep sensory loss was high. Abnormal deep tendon reflex was 38 (79.1%) and 11 (78.5%), atrophy was 24 (50%) and 2 (14.2%), loss of pain was 18 (37%) and 4 (28.5%), loss of touch was 32 (66%) and 8 (57%), and deep sensory loss was 42 (87.5%) and 12 (85.7%) in men and women respectively.

Conclusions Diabetes mellitus leads to neuropathies of more than one type and all contribute to diabetic foot pathogenesis. Clinical symptoms and signs, as well as nerve conduction studies may be different between men and women with diabetic foot. Motor neuropathies may constitute an important prognostic parameter in men. Mononeuropathies sometimes reflect more severe involvement and peroneal and ulnar neuropathy is remarkable among these.