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Year : 2022  |  Volume : 28  |  Issue : 2  |  Page : 154-157

Incidence and role of large vessel disease in diabetic foot

1 Department of General Surgery, KIMSHEALTH Hospital, Thiruvananthapuram, Kerala, India
2 Department of Family Medicine, KIMSHEALTH Hospital, Thiruvananthapuram, Kerala, India

Correspondence Address:
Dr. Akash Sasidharan
Department of General Surgery, KIMSHEALTH Hospital, Thiruvananthapuram - 695 029, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ksj.ksj_42_22

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Introduction: Diabetic patients are at risk for considerable morbidity as a result of chronic foot ulceration and infection, including limb loss. Diabetic foot infections are usually a consequence of skin ulceration from ischaemia or trauma to a neuropathic foot. The accurate diagnosis of the underlying cause is very important in planning the treatment. The aim of the study was to study the incidence and role of large vessel disease in patients with diabetic foot. Materials and Methods: Seventy-five patients admitted with features of diabetic foot and its complications were included in the study after excluding patients of comorbid medical illness. The presence of macrovasculopathy was assessed by examination for peripheral pulses, followed by assessment using arterial Doppler amongst patients with macrovasculopathy, those with gangrene or non-healing ulcers and those who underwent amputations or disarticulations were analysed. Results: Clinically, dorsalis pedis artery pulses were absent in 81.3% and posterior tibial artery pulses were absent in 54.7%. In arterial Doppler, involvement is 66.7% for dorsalis pedis and 68% for posterior tibial. Fifty-six percentage of patients ended up having poor outcomes in the form of amputations or disarticulations. There is a significant incidence of large vessel disease, especially in elderly patients who were diabetic for more than 10 years. Large vessel disease seems to have a significant role in the final outcome of diabetic foot complications. Conclusions: Vasculopathy is a strong risk factor in the development of diabetic foot lesions. An arterial Doppler will help detect involvement early in cases presenting with diabetic foot complications. The presence of diabetic microvascular disease imparts an even greater importance on the early detection and treatment of significant macrovascular disease.

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