Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency

Comorbid chronic venous insufficiency (CVI) and type 2 diabetes mellitus (T2DM) are common, particularly in older people. The severity of DM and its complications can worsen the course of CVI and affect its management.Aim. To assess the impact of T2DM on lesions of the lower extremities in patients...

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Autores principales:	Anna A. Shlyakova, Leonid G. Strongin, Maksim N. Kudykin, Кsenia G. Korneva
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2016
Materias:	chronic venous insufficiency type 2 diabetes mellitus diabetic macroangiopathy diabetic polyneuropathy diabetic microangiopathy Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/f6452961f50b401581c48b4b1b03b63c
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spelling	oai:doaj.org-article:f6452961f50b401581c48b4b1b03b63c2021-11-14T09:00:20ZClinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency2072-03512072-037810.14341/DM200349-12https://doaj.org/article/f6452961f50b401581c48b4b1b03b63c2016-07-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/7586https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Comorbid chronic venous insufficiency (CVI) and type 2 diabetes mellitus (T2DM) are common, particularly in older people. The severity of DM and its complications can worsen the course of CVI and affect its management.Aim. To assess the impact of T2DM on lesions of the lower extremities in patients with CVI.Materials and methods. Eighty patients with CVI of the lower limbs were examined. Forty patients had T2DM (main group) and 40 patients did not have T2DM (control group). Physical examination, clinical and biochemical tests, ultrasound scanning of veins and arteries of the lower extremities and electroneuromyography (ENMG) of the lower extremities were performed for all patients. The state of the microvasculature was studied by laser Doppler flowmetry (LDF) for 15 patients in the main group and 15 patients in the control group.Results. T2DM exacerbated the course of CVI, which was clinically characterized by a greater severity of trophic (p = 0.0001) and oedema (p = 0.03) syndromes. Morphological changes in the venous blood flow in patients with T2DM with CVI were characterized by bilateral lesions (p = 0.03), more frequent failure of sapheno-femoral anastomosis (p = 0.02) and perforating veins of the lower leg (p = 0.0004). The pathogenesis of such complications was associated with diabetic factors, including hyperglycaemia, НbА1с > 10%, duration of DM > 10 years and the presence diabetic microangiopathy of the lower limbs. Diabetic macroangiopathy and polyneuropathy were associated with disruption of the morphological and functional characteristics of the venous system and the disruption of the microcirculation in the lower extremities, contributing to increased oedema and trophic changes. At the same time, the presence of diabetic neuropathy masked the symptoms of CVI due to reductions in pain (p = 0.0004).Conclusion. Diabetes exacerbates the course of CVI due to poor glycaemic control (HbA1c > 10%), long duration of diabetes (>10 years) and the presence of macroangiopathy in the lower extremities. Diabetic neuropathy of the lower limbs and diabetic microangiopathy aggravates the venous disease through disruption of microcirculation and increases the expression of trophic changes in the lower extremities.Anna A. ShlyakovaLeonid G. StronginMaksim N. KudykinКsenia G. KornevaEndocrinology Research Centrearticlechronic venous insufficiencytype 2 diabetes mellitusdiabetic macroangiopathydiabetic polyneuropathydiabetic microangiopathyNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 19, Iss 3, Pp 212-220 (2016)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	chronic venous insufficiency type 2 diabetes mellitus diabetic macroangiopathy diabetic polyneuropathy diabetic microangiopathy Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	chronic venous insufficiency type 2 diabetes mellitus diabetic macroangiopathy diabetic polyneuropathy diabetic microangiopathy Nutritional diseases. Deficiency diseases RC620-627 Anna A. Shlyakova Leonid G. Strongin Maksim N. Kudykin Кsenia G. Korneva Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency
description	Comorbid chronic venous insufficiency (CVI) and type 2 diabetes mellitus (T2DM) are common, particularly in older people. The severity of DM and its complications can worsen the course of CVI and affect its management.Aim. To assess the impact of T2DM on lesions of the lower extremities in patients with CVI.Materials and methods. Eighty patients with CVI of the lower limbs were examined. Forty patients had T2DM (main group) and 40 patients did not have T2DM (control group). Physical examination, clinical and biochemical tests, ultrasound scanning of veins and arteries of the lower extremities and electroneuromyography (ENMG) of the lower extremities were performed for all patients. The state of the microvasculature was studied by laser Doppler flowmetry (LDF) for 15 patients in the main group and 15 patients in the control group.Results. T2DM exacerbated the course of CVI, which was clinically characterized by a greater severity of trophic (p = 0.0001) and oedema (p = 0.03) syndromes. Morphological changes in the venous blood flow in patients with T2DM with CVI were characterized by bilateral lesions (p = 0.03), more frequent failure of sapheno-femoral anastomosis (p = 0.02) and perforating veins of the lower leg (p = 0.0004). The pathogenesis of such complications was associated with diabetic factors, including hyperglycaemia, НbА1с > 10%, duration of DM > 10 years and the presence diabetic microangiopathy of the lower limbs. Diabetic macroangiopathy and polyneuropathy were associated with disruption of the morphological and functional characteristics of the venous system and the disruption of the microcirculation in the lower extremities, contributing to increased oedema and trophic changes. At the same time, the presence of diabetic neuropathy masked the symptoms of CVI due to reductions in pain (p = 0.0004).Conclusion. Diabetes exacerbates the course of CVI due to poor glycaemic control (HbA1c > 10%), long duration of diabetes (>10 years) and the presence of macroangiopathy in the lower extremities. Diabetic neuropathy of the lower limbs and diabetic microangiopathy aggravates the venous disease through disruption of microcirculation and increases the expression of trophic changes in the lower extremities.
format	article
author	Anna A. Shlyakova Leonid G. Strongin Maksim N. Kudykin Кsenia G. Korneva
author_facet	Anna A. Shlyakova Leonid G. Strongin Maksim N. Kudykin Кsenia G. Korneva
author_sort	Anna A. Shlyakova
title	Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency
title_short	Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency
title_full	Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency
title_fullStr	Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency
title_full_unstemmed	Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency
title_sort	clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency
publisher	Endocrinology Research Centre
publishDate	2016
url	https://doaj.org/article/f6452961f50b401581c48b4b1b03b63c
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Clinical and pathogenetic features of lesions of the lower extremities in patients with type 2 diabetes mellitus and chronic venous insufficiency

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