Cómo citar
1.
Lopez Diaz JM, García Ugalde JP. Factores de riesgo cardiovasculares asociados a pie diabético. Rev.méd.sinerg. [Internet]. 1 de marzo de 2019 [citado 22 de diciembre de 2024];4(3):4 - 20. Disponible en: https://revistamedicasinergia.com/index.php/rms/article/view/176
Resumen
Factores cardiovasculares asociados a Pie Diabético
Introducción: El pie diabético una de las complicaciones más frecuentes de la Diabetes mellitus con impacto funcional, económico y elevada morbimortalidad, pudiendo ser evitado hasta en 75% de casos con modificación sus factores de riesgo; en la literatura mundial la frecuencia de los factores de riesgo cardiovascular en el Pie Diabético son referidos en pocas veces de manera individual, por lo que su correcta identificación daría una base más sistemática para su abordaje.
Objetivo: Identificar los Factores cardiovasculares en pacientes con Diabetes mellitus que están asociados a pie diabético.
Material y métodos: El estudio es observacional, analítico con diseño trasversal, en pacientes adultos en área de urgencias con diagnóstico de Diabetes mellitus. Se estudiaron las variables: presencia o ausencia de pie diabético, edad, género, hipertensión, sobrepeso, tabaquismo, Dislipidemia. Mediante R Studio 1.0.153, se determinó normalidad, se realizaron correlaciones y comparaciones entre variables.
Análisis estadístico: Se obtuvieron 201 pacientes, media de edad: 59.4±15.3 años, 48.76% de género masculino y 51.24% femenino; prevalencia de pie Diabético de 31.34% (63 pacientes). Se analizó cada variable, siendo no estadísticamente significativas: edad (p=0.2172), Sexo (p= 0.8796), sobrepeso u Obesidad (p= 0.1423), Tabaquismo (p= 0.4993) y dislipidemia (p=0.8699). Existió una asociación estadísticamente significativa para hipertensión mediante Prueba Exacta de Fisher (p: 0.001156), con intervalo de confianza de 95% (1.556-9.603) y Odds Ratio de 3.6456.
Conclusiones: De las variables señaladas como factores de riesgo cardiovascular solo la hipertensión arterial sistémica presento correlación estadísticamente significativa con el pie diabético.
Palabras clave
hipertensión. factores de riesgo. pie diabético.
Citas
1. William TC GB. Standards of Medical Care in Diabetes. Diabetes Care. 2017 Enero; 40(1). Disponible en: http://www.epi.uff.br/wp-content/uploads/2013/10/dc_40_s1_final.pdf
2. Nagase, Takashi et al. Screening of Foot Inflammation in Diabetic Patients by Non-Invasive Imaging Modalities. Global Perspective on Diabetic Foot Ulcerations. 2012. Disponible en: https://www.semanticscholar.org/paper/3-Screening-of-Foot-Inflammation-in-Diabetic-by-Nagase-Sanada/8a9d54c32f368b53a329e2bb6349abe7ca6cab11
3. Cheng AY. Introduction. Canadian Journal of Diabetes. 2013 04;37:S1-S3. https://doi.org/10.1016/j.jcjd.2013.01.009
4. Rangel JT. Proporción de incidencia de amputaciones en pacientes con lesiones del pie diabético. Revista Mexicana de Angiologia. 2015 Enero; 43(1). Disponible en: http://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=57567
5. Namgoong S, Jung S, Han S, Jeong S, Dhong E, Kim W. Risk factors for major amputation in hospitalised diabetic foot patients. International Wound Journal. 2015 Oct 19;13:13-19. https://doi.org/10.1111/iwj.12526
6. Bus SA, van Netten JJ, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, Price PE, . IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes/Metabolism Research and Reviews. 2016 01;32:16-24. https://doi.org/10.1002/dmrr.2696
7. Tratamiento de la Diabetes Mellitus tipo 2 en el primer nivel de el primer nivel de Atención. Instituto Mexicano del Seguro Social. 2014. Disponible en: http://www.cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/718_GPC_
Tratamiento_de_diabetes_mellitus_tipo_2_/718GER.pdf
8. Pinto A, Tuttolomondo A, Di Raimondo D, Fernandez P, La Placa S, Di Gati M, Licata G. Cardiovascular risk profile and morbidity in subjects affected by type 2 diabetes mellitus with and without diabetic foot. Metabolism. 2008 05;57(5):676-682. https://doi.org/10.1016/j.metabol.2008.01.004
9. Tuttolomondo A, Maida C, Pinto A. Diabetic Foot Syndrome as a Possible Cardiovascular Marker in Diabetic Patients. Journal of Diabetes Research. 2015;2015:1-12. https://doi.org/10.1155/2015/268390
10. Hung S, Huang Y, Hsu L, Chen C, Yang H, Sun J, Lin C, Wang C. Treatment for Diabetic Foot Ulcers Complicated by Major Cardiac Events. Canadian Journal of Diabetes. 2015 06;39(3):183-187. https://doi.org/10.1016/j.jcjd.2014.11.002
11. Dietrich I, Braga GA, de Melo FG, da Costa Silva Silva ACC. The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review. Current Atherosclerosis Reports. 2017 Oct 02;19(11). https://doi.org/10.1007/s11883-017-0680-z
12. Husten CG. How should we define light or intermittent smoking? Does it matter?. Nicotine & Tobacco Research. 2009 03 05;11(2):111-121. https://doi.org/10.1093/ntr/ntp010
13. U.S. Department of Health and Human. The Health consequences of smoking-50 years of progress. A report of the Surgeon General. Centers for Disease Control and Prevention and Health Promotion. 2014. Disponible en: https://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.html
14. Morris PB, Ference BA, Jahangir E, Feldman DN, Ryan JJ, Bahrami H, El-Chami MF, Bhakta S, Winchester DE, Al-Mallah MH, Sanchez Shields M, Deedwania P, Mehta LS, Phan BAP, Benowitz NL. Cardiovascular Effects of Exposure to Cigarette Smoke and Electronic Cigarettes. Journal of the American College of Cardiology. 2015 09;66(12):1378-1391. https://doi.org/10.1016/j.jacc.2015.07.037
15. Clayton W, Elasy T. A review of the Pathophysiology , classification , and treatment of foot ulcers in Diabetic Patients. Clinical Diabetes. 2009; 27(2). Disponible en: https://www.semanticscholar.org/paper/A-review-of-the-Pathophysiology-%2C-classification-%2C-Clayton-Elasy/cc757ade5358ee67d2f61fa8816feaf9c0ebedb1
16. Rebolledo FA. The Pathogenesis of the Diabetic Foot Ulcer: Prevention and Management. Global Perspective on Diabetic Foot Ulcerations. 2011; 9(29). Disponible en: https://pdfs.semanticscholar.org/50ce/4b622a87ebfc4a75ddbc1e2ff490b9
8c6acf.pdf_ga=2.58329069.616562820.1551309255-1581848156.1551028403
17. Martínez F, Guerrero G, Ochoa P, Anaya R, Muñoz J. Diagnóstico, clasificación y tratamiento de las infecciones en pie diabético. Cirugia General. 2012; 34(32). Disponible en: http://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=39853
18. Brownrigg J, Apelqvist J, Bakker K, Schaper N, Hinchliffe R. Evidence-based Management of PAD & the Diabetic Foot. European Journal of Vascular and Endovascular Surgery. 2013 06;45(6):673-681. https://doi.org/10.1016/j.ejvs.2013.02.014
19. Sinwar PD. The diabetic foot management – Recent advance. International Journal of Surgery. 2015 03;15:27-30. https://doi.org/10.1016/j.ijsu.2015.01.023
20. Kumar A. A New Classification of Diabetic Foot Complications: A simple and effective teaching tool. Journal of Diabetic Foot Complications. 2012; 4(1). Disponible en: http://jdfc.org/2012/volume-4-issue-1/a-new-classification-of-diabetic-foot-complications-a-simple-and-effective- 20. Kumar A. A New Classification of Diabetic Foot Complications: A simple and effective teaching tool. Journal of Diabetic Foot Complications. 2012; 4(1). Disponible en: http://jdfc.org/2012/volume-4-issue-1/a-new-classification-of-diabetic-foot-complications-a-simple-and-effective-teaching-tool/
21. Bakker K, Apelqvist J, Schaper NC, . Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/Metabolism Research and Reviews. 2012 01 23;28:225-231. https://doi.org/10.1002/dmrr.2253
22. Van Netten JJ, Price PE, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, Bus SA, . Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes/Metabolism Research and Reviews. 2016 01;32:84-98. https://doi.org/10.1002/dmrr.2701
23. Jiang HJ, Stryer D, Friedman B, Andrews R. Multiple Hospitalizations for Patients With Diabetes. Diabetes Care. 2003 05 01;26(5):1421-1426. https://doi.org/10.2337/diacare.26.5.1421
24. Prevención, diagnóstico y tratamiento oportuno del pie diabético en el primer nivel de atención. Secretaria de Salud. 2012. Disponible en: https://cenetec-difusion.com/gpc-sns/?p=660
25. Sohn M, Meadows JL, Oh EH, Budiman-Mak E, Lee TA, Stone NJ, Pearce WB. Statin use and lower extremity amputation risk in nonelderly diabetic patients. Journal of Vascular Surgery. 2013 Dec;58(6):1578-1585.e1. https://doi.org/10.1016/j.jvs.2013.06.069
26. Bus SA, van Netten JJ. A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable. Diabetes/Metabolism Research and Reviews. 2016 01;32:195-200. https://doi.org/10.1002/dmrr.2738
27. Brownrigg J, Apelqvist J, Bakker K, Schaper N, Hinchliffe R. Evidence-based Management of PAD & the Diabetic Foot. European Journal of Vascular and Endovascular Surgery. 2013 06;45(6):673-681. https://doi.org/10.1016/j.ejvs.2013.02.014
28. Tuttolomondo A, Maida C, Pinto A. Diabetic Foot Syndrome as a Possible Cardiovascular Marker in Diabetic Patients. Journal of Diabetes Research. 2015;2015:1-12. https://doi.org/10.1155/2015/268390
29. William T. Cefalu GB. Standards of Medical Care in Diabetes. Diabetes care. 2017; 40(1). Disponible en: http://care.diabetesjournals.org/content/diacare/suppl/2016/12/15/40.
Supplement_1.DC1/DC_40_S1_final.pdf
2. Nagase, Takashi et al. Screening of Foot Inflammation in Diabetic Patients by Non-Invasive Imaging Modalities. Global Perspective on Diabetic Foot Ulcerations. 2012. Disponible en: https://www.semanticscholar.org/paper/3-Screening-of-Foot-Inflammation-in-Diabetic-by-Nagase-Sanada/8a9d54c32f368b53a329e2bb6349abe7ca6cab11
3. Cheng AY. Introduction. Canadian Journal of Diabetes. 2013 04;37:S1-S3. https://doi.org/10.1016/j.jcjd.2013.01.009
4. Rangel JT. Proporción de incidencia de amputaciones en pacientes con lesiones del pie diabético. Revista Mexicana de Angiologia. 2015 Enero; 43(1). Disponible en: http://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=57567
5. Namgoong S, Jung S, Han S, Jeong S, Dhong E, Kim W. Risk factors for major amputation in hospitalised diabetic foot patients. International Wound Journal. 2015 Oct 19;13:13-19. https://doi.org/10.1111/iwj.12526
6. Bus SA, van Netten JJ, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, Price PE, . IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes/Metabolism Research and Reviews. 2016 01;32:16-24. https://doi.org/10.1002/dmrr.2696
7. Tratamiento de la Diabetes Mellitus tipo 2 en el primer nivel de el primer nivel de Atención. Instituto Mexicano del Seguro Social. 2014. Disponible en: http://www.cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/718_GPC_
Tratamiento_de_diabetes_mellitus_tipo_2_/718GER.pdf
8. Pinto A, Tuttolomondo A, Di Raimondo D, Fernandez P, La Placa S, Di Gati M, Licata G. Cardiovascular risk profile and morbidity in subjects affected by type 2 diabetes mellitus with and without diabetic foot. Metabolism. 2008 05;57(5):676-682. https://doi.org/10.1016/j.metabol.2008.01.004
9. Tuttolomondo A, Maida C, Pinto A. Diabetic Foot Syndrome as a Possible Cardiovascular Marker in Diabetic Patients. Journal of Diabetes Research. 2015;2015:1-12. https://doi.org/10.1155/2015/268390
10. Hung S, Huang Y, Hsu L, Chen C, Yang H, Sun J, Lin C, Wang C. Treatment for Diabetic Foot Ulcers Complicated by Major Cardiac Events. Canadian Journal of Diabetes. 2015 06;39(3):183-187. https://doi.org/10.1016/j.jcjd.2014.11.002
11. Dietrich I, Braga GA, de Melo FG, da Costa Silva Silva ACC. The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review. Current Atherosclerosis Reports. 2017 Oct 02;19(11). https://doi.org/10.1007/s11883-017-0680-z
12. Husten CG. How should we define light or intermittent smoking? Does it matter?. Nicotine & Tobacco Research. 2009 03 05;11(2):111-121. https://doi.org/10.1093/ntr/ntp010
13. U.S. Department of Health and Human. The Health consequences of smoking-50 years of progress. A report of the Surgeon General. Centers for Disease Control and Prevention and Health Promotion. 2014. Disponible en: https://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.html
14. Morris PB, Ference BA, Jahangir E, Feldman DN, Ryan JJ, Bahrami H, El-Chami MF, Bhakta S, Winchester DE, Al-Mallah MH, Sanchez Shields M, Deedwania P, Mehta LS, Phan BAP, Benowitz NL. Cardiovascular Effects of Exposure to Cigarette Smoke and Electronic Cigarettes. Journal of the American College of Cardiology. 2015 09;66(12):1378-1391. https://doi.org/10.1016/j.jacc.2015.07.037
15. Clayton W, Elasy T. A review of the Pathophysiology , classification , and treatment of foot ulcers in Diabetic Patients. Clinical Diabetes. 2009; 27(2). Disponible en: https://www.semanticscholar.org/paper/A-review-of-the-Pathophysiology-%2C-classification-%2C-Clayton-Elasy/cc757ade5358ee67d2f61fa8816feaf9c0ebedb1
16. Rebolledo FA. The Pathogenesis of the Diabetic Foot Ulcer: Prevention and Management. Global Perspective on Diabetic Foot Ulcerations. 2011; 9(29). Disponible en: https://pdfs.semanticscholar.org/50ce/4b622a87ebfc4a75ddbc1e2ff490b9
8c6acf.pdf_ga=2.58329069.616562820.1551309255-1581848156.1551028403
17. Martínez F, Guerrero G, Ochoa P, Anaya R, Muñoz J. Diagnóstico, clasificación y tratamiento de las infecciones en pie diabético. Cirugia General. 2012; 34(32). Disponible en: http://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=39853
18. Brownrigg J, Apelqvist J, Bakker K, Schaper N, Hinchliffe R. Evidence-based Management of PAD & the Diabetic Foot. European Journal of Vascular and Endovascular Surgery. 2013 06;45(6):673-681. https://doi.org/10.1016/j.ejvs.2013.02.014
19. Sinwar PD. The diabetic foot management – Recent advance. International Journal of Surgery. 2015 03;15:27-30. https://doi.org/10.1016/j.ijsu.2015.01.023
20. Kumar A. A New Classification of Diabetic Foot Complications: A simple and effective teaching tool. Journal of Diabetic Foot Complications. 2012; 4(1). Disponible en: http://jdfc.org/2012/volume-4-issue-1/a-new-classification-of-diabetic-foot-complications-a-simple-and-effective- 20. Kumar A. A New Classification of Diabetic Foot Complications: A simple and effective teaching tool. Journal of Diabetic Foot Complications. 2012; 4(1). Disponible en: http://jdfc.org/2012/volume-4-issue-1/a-new-classification-of-diabetic-foot-complications-a-simple-and-effective-teaching-tool/
21. Bakker K, Apelqvist J, Schaper NC, . Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/Metabolism Research and Reviews. 2012 01 23;28:225-231. https://doi.org/10.1002/dmrr.2253
22. Van Netten JJ, Price PE, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, Bus SA, . Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes/Metabolism Research and Reviews. 2016 01;32:84-98. https://doi.org/10.1002/dmrr.2701
23. Jiang HJ, Stryer D, Friedman B, Andrews R. Multiple Hospitalizations for Patients With Diabetes. Diabetes Care. 2003 05 01;26(5):1421-1426. https://doi.org/10.2337/diacare.26.5.1421
24. Prevención, diagnóstico y tratamiento oportuno del pie diabético en el primer nivel de atención. Secretaria de Salud. 2012. Disponible en: https://cenetec-difusion.com/gpc-sns/?p=660
25. Sohn M, Meadows JL, Oh EH, Budiman-Mak E, Lee TA, Stone NJ, Pearce WB. Statin use and lower extremity amputation risk in nonelderly diabetic patients. Journal of Vascular Surgery. 2013 Dec;58(6):1578-1585.e1. https://doi.org/10.1016/j.jvs.2013.06.069
26. Bus SA, van Netten JJ. A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable. Diabetes/Metabolism Research and Reviews. 2016 01;32:195-200. https://doi.org/10.1002/dmrr.2738
27. Brownrigg J, Apelqvist J, Bakker K, Schaper N, Hinchliffe R. Evidence-based Management of PAD & the Diabetic Foot. European Journal of Vascular and Endovascular Surgery. 2013 06;45(6):673-681. https://doi.org/10.1016/j.ejvs.2013.02.014
28. Tuttolomondo A, Maida C, Pinto A. Diabetic Foot Syndrome as a Possible Cardiovascular Marker in Diabetic Patients. Journal of Diabetes Research. 2015;2015:1-12. https://doi.org/10.1155/2015/268390
29. William T. Cefalu GB. Standards of Medical Care in Diabetes. Diabetes care. 2017; 40(1). Disponible en: http://care.diabetesjournals.org/content/diacare/suppl/2016/12/15/40.
Supplement_1.DC1/DC_40_S1_final.pdf
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