ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ MỘT SỐ YẾU TỐ LIÊN QUAN CỦA LOÉT BÀN CHÂN TÁI PHÁT TRÊN BỆNH NHÂN ĐÁI THÁO ĐƯỜNG

Abstract

Ojectives: "Describe the clinical and laboratory characteristics of recurrent DFU among patients with type 2 diabetes at Central Hospital of Endocrine " and "Identify associated factors related to recurrent DFU among these patients". Method: A cross-sectional study was conducted on 210 type 2 diabetic patients who were diagnosed with diabetic foot ulcers at Central Hospital of Endocrine from July 2023 to December 2023. Results: The prevalence of patients with recurrent DFU was 47.62%. The median of reccurrent time was mostly within 1 year and medium time from recurrent DFU onset to hospital admission was mainly over 1 month (accounting for 52%). Foreign bodies and calluses were the two most common exogenous causes of recurrent DFU. The most common DFU locations were on the toes/between the toes (54%) and plantar (30%) with DFU severity mainly at grade 3 and 4 and ulcer area ranging from 3cm² or more. All recurrent DFU were infectted. There were 50% of patients have lower extremity arterial diseas. 53% of patients had images of lower limb ischemia by Dopper ultrasound and 63% of patients had images of foot bone loss on X-ray. Groups of patients who exercise regularly or patients had diseases such as hypertension, chronic kidney disease, lower limb arterial disease, have a history of lower limb revascularization, a history of amputation, or suffeing of foot deformities had higher recurrent rate ofDFU than the group of patients without the above conditions. The group of patients with HbA1C index > 7.5% and glomerular filtration rate < 60ml/min/1.73m2 has a higher rate of recurrent DFU than the group of patients with HbA1C ≤ 7.5% and glomerular filtration rate ≥ 60ml/min/1.73m2. The group of patients with recurrent DFU had higher mean ​​of CRP-hs and LDL-c index and lower mean value of HDL-c index than the group of patients without recurrent DFU. Conclusion: The prevalence of recurrent DFU in patients with type 2 diabetes was quite high. The location of the ulcers was mainly on the toes or between the toes and theplantar. The ulcers were often severe and infected. Patients who have had foot ulcers need guidance on monitoring and care to prevent foot ulcers from recurring. The problems that patients and healthcare providers should pay attention included maintaining exercise, controlling and monitoring diabetes and diseases such as hypertension, chronic kidney disease, lower limb arterial disease, controlling HbA1C indicators, glomerular filtration rate, CRP-hs and HDL-c. At the same time, it is necessary to instruct patients on good living habits to avoid recurring DFU.