January 1, 1986Diabetic Medicine
Autonomic Neuropathy and Diabetic Foot Ulceration
Key result
A history of foot ulceration in diabetic patients was associated with significantly increased diastolic flow (PI 4.28 vs 7.80, p<0.002) and reduced heart rate changes (p<0.001) compared to those without ulcers.
Why the study?
Is severe autonomic neuropathy associated with foot ulceration in insulin-dependent diabetic patients?
Population
122 insulin-dependent diabetic patients, divided into three groups: 28 with a recent history of foot…
Comparison
Recent history of foot ulceration vs Peripheral neuropathy without ulceration, and no…
Design
Cross-sectional
Authors
Discussion
Loading...
Member takes
Implication
Supports autonomic neuropathy association with diabetic foot ulcers; hypothesis-generating, causality unproven, needs prospective confirmation.
Study Design
Type
Observational (n=122)
Structured PICO
Is severe autonomic neuropathy associated with foot ulceration in insulin-dependent diabetic patients?
P
Population
122 insulin-dependent diabetic patients categorized by history of foot ulceration and peripheral neuropathy.
E
Exposure
Recent history of foot ulceration
C
Comparator
Peripheral neuropathy without ulceration, and no neuropathy
O
Outcome
Autonomic function (heart rate changes during deep breathing and on standing, and sympathetic function assessed by peripheral arterial diastolic flow patterns/pulsatility index)surrogate
Main Result
Absolute Event Rate: 4.28% vs 7.8%
p-value: p=<0.002
Severely abnormal autonomic function is strongly associated with neuropathic foot ulceration in insulin-dependent diabetic patients, though causality remains unproven.
Limitations
- A causal relationship between autonomic neuropathy and foot ulceration has not been established.
- Cross-sectional design cannot establish a causal relationship between autonomic neuropathy and foot ulceration.
Cite This Study
Edmonds et al. (1986) conducted an observational in Insulin-dependent diabetes mellitus (n=122). History of foot ulceration vs. Peripheral neuropathy without ulceration, and no neuropathy was evaluated on Sympathetic function assessed by pulsatility index (PI) from peripheral arterial diastolic flow (p=<0.002). A history of foot ulceration in diabetic patients was associated with significantly increased diastolic flow (PI 4.28 vs 7.80, p<0.002) and reduced heart rate changes (p<0.001) compared to those without ulcers.