Significance of reinforcing management on limb salvage therapy in patients at high risk for diabetic foot

doi:10.3321/j.issn:1673-8225.2003.18.010

Abstract：Aim To evaluate the efficacy of the comprehensive reinforcing management and medical therapy to reduce amputation incidence and promote quality of life in diabetic patients at high risk for diabetic foot(DF).Methods 123 diabetic patients at high risk for diabetic foot were employed to participate in a 2-year prospective study.All of them received a routine education and foot care program for type 2 diabetes in Diabetic Care Center, and were randomly divided into two sex and age-matched groups: reinforcing management group(n=65,group A) and standard management group(n=58, group B).Diabetic education questionnaire were conducted in all the patients before and after education. At the end of the investigation, the differences between group A and group B were evaluated in the diabetic knowledge, foot care knowledge, blood sugar control and incidence of diabetic foot ulcer and amputation. Results There was an insignificant difference between the general and foot care knowledge of the group A and B before and after 1 month intervention (P >0.05), but a significant difference between the two groups after 1- 2 year intervention(P< 0.001).The concentration of HBA1c in the group A was (7.1± 2.3)% , significantly lower than that of the group B [(8.5± 4.2)% ,t=2.310,P< 0.05]. The average systolic pressure and diastolic pressure of the group A were ( 142± 10) mmHg and (80± 10)mmHg respectively, significantly lower than those of the group B [(158± 9) mmHg and (92± 10)mmHg respectively,t=9.019, 6.647,P< 0.05].The concentrations of total cholesterol and triacylglycerol in the group A were(4.4± 1.1)mmol/L and (1.8± 0.9)mmol/L respectively, significantly lower than those in the group B (5.6± 2.6)mmol/L and (2.5± 1.8)mmol/L respectively,t=2.804, 2.745,P< 0.05]. The DF incidence and amputated rate of the group A were 7.7% and 3.1% respectively, significantly lower than those of the group B(20.7% and 13.8% respectively, t=4.347,4.712,P< 0.05). Conclusion The reinforcing management was beneficial to reduce the incidence of diabetic foot and amputation, and meanwhile to promote the quality of life and save medical cost.