Estimation of practical value of physical symptoms of extremity ischemia in diabetes mellitus patients


DOI: https://dx.doi.org/10.18565/therapy.2018.5.47-53

D.M. Afanasjeva, M.M.Bakhteeva, O.V.Udovichenko, D.O. Ladygina, T.Ju. Demidova

1 FSBEI of Higher Education «N.I. Pirogov RNRMU» of the Ministry of Healthcare of Russia, Moscow, Russia; 2 FSBI «Central clinical hospital with ambulatory-care clinic» of Department of Presidential Affairs, Moscow, Russia
The aim of the research: to evaluate the diagnostic value of classical visual signs of extremity ischemia in patients with diabetes mellitus. Material and methods. 30 patients with diabetes were examined independently by two students and an experienced doctor. Visual signs of extremity ischemia were compared with data from ultrasound duplex scanning of lower extremity arteries (UZDS). Results. At UZD, atherosclerotic lesion is revealed in 30% of the extremities. The reproducibility of visual signs of ischemia was 44-92%, but the diagnostic accuracy was low (22-68%). Palpation of the pulse was characterized by high reproducibility (71-85%) and acceptable diagnostic accuracy (73-77%). The conclusion. In the studied population of patients with diabetes mellitus, the informative value of the «classic» signs of extremity ischemia was low. It is very helpful to take into account the obtained data in teaching guidances development. Palpation of the pulse on the feet demonstrated better information and reproducibility. Palpable pulse excludes severe stenosis in the basin of this artery, and non-palpable requires instrumental examination of blood flow.
Keywords: diabetes, atherosclerosis, diabetic foot syndrome, visual signs, extremity ischemia, ultrasound duplex scanning
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    • About the Autors

    Darja M. Afanasjeva, the Department of endocrinology of general medicine Faculty of N.I. Pirogov RNRMU, 117997, Moscow, 1 Ostrovityanova St., e-mail: afanasjewa.darya@yandex.ru
    Maria.M. Bakhteeva, the Department of endocrinology of general medicine Faculty of N.I. Pirogov RNRMU, 117997, Moscow, 1 Ostrovityanova St., e-mail: maria.bahteeva1@yandex.ru
    Udovichenko Oleg V., MD, a physician of diabetic foot office, the Department of endocrinology of the Central clinical hospital of Administrative affairs of the President of the Russian Federation, 121359, Moscow, 15 Marshala Timoshenko St., e-mail: ovu2003@mail.ru, Тel.: +7(495)530 05 45
    Darja.O. Ladygina, PhD, head of the Department of endocrinology of the Central clinical hospital of Administrative affairs of the President of the Russian Federation, e-mail: ladygina.do@gmail.com, Тел.: (495) 530 05 45
    Tatjana Ju. Demidova, MD, professor, head of the Department of endocrinology of general medicine Faculty of N.I. Pirogov RNRMU, 117997, Moscow, 1 Ostrovityanova St., e-mail: t.y.demidova@gmail.com, Тел.: 8 (499) 179-85-06

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