Abstract

MARTINEZ, Octavio  and  CASTRILLON, Víctor Alfonso. Diabetes mellitus. Acta Med Colomb [online]. 2010, vol.35, n.2, pp.40-47. ISSN 0120-2448.

Objective: to characterize diabetes mellitus as an independent risk factor for the severity of critical lower limb ischemia and for viability of affected limbs. Context and type of study: Hospital based census on registers of all surgical patients for revascularization or major amputation by atherosclerotic critical ischemia or lower limbs from 1^st January, 2005 until 30^th June, 2009. Units of analysis were clinical records of patients who met the study's admission criteria. Material and methods: univariate and bivariate descriptions depending on type and distribution of variables. Detection of confounders and modifiers of effects of the association between diabetes and severity of critical ischemia, and diabetes and intervention, by stratification in the analysis. Results: adjusted for the positive confounding effect of hypertension, odds of diabetes mellitus in patients with ischemic disease Fontaine IV was 8.23 to patients with Fontaine III (X²_{MH 1df} 13.18; p value = 0.0003). Controlled for the positive confounding effect of chronic renal failure, odds of diabetes mellitus in patients with Fontaine IV was 7.99 to patients with Fontaine III (X²_{MH 1df} 12.00; p value = 0.0005). Controlled for the severity of critical lower limb ischemia, patients with diabetes mellitus had a possibility of primary major amputation 6.32 in relation to non-diabetic patients primary amputation (X²_{MH 1df} 8.455; p value = 0.0036). Conclusion: Diabetes mellitus is an independent risk factor for the development of the most severe state of critical ischemia of the lower limbs, Fontaine IV, after adjusting for hypertension and chronic renal failure. Also, diabetes became an independent risk factor for the viability of the limb with critical ischemia. (Acta Med Colomb 2010; 35: 40-47)

Keywords : Diabetes mellitus; critical lower limb ischemia.

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