Results of the prospective examination of diabetes mellitus patients with trophic ulcers of the feet

This paper presents the results of long-term (5,5±1,4 yers) follow-up of 356 diabetic patients with feet ulcers. Total mortality, cardiovascular mortality, mortality due to amputation, amputation rates and development of new ulcer were separately evaluated for patients with neuropathic (group 1) and neuroischemic ulcers (group 2). Incidence of all studied endpoints except new ulcer development was significantly higher in group 2: relative risk for total mortality 1,95, for cardiovascular mortality-2,12, for mortality due to amputation -4,1, for amputation rates - 2,01. The probability of new ulcer was slightly higher in neuropathic patients: relative risk 0,96 (p=0,03). Age, ischemic heart disease and severity of diabetic nephropathy were independent factors for mortality in both groups. Significance of duration of diabetes mellitus for mortality and amputations was noticed only for group 1. We concluded that low extremity ischemia worsens the prognosis for life and for foot. Duration of diabetes and severity of renal impairment due to nephropathy are important negative prognostic factors in neuropathic patients comparing to neuroischemic ones.