Prognostic Factors for the Development of Amputations in People with Type 2 Diabetes Mellitus
Author(s): Victor Horacio Orozco-Covarrubias*, Carlos Enrique Cabrera-Pivaral, Maria de los Angeles Aguilera-Velasco, Noe Alfaro-Alfaro, Guillermo Gonzalez-Galvez, Blanca Leticia Sanchez-Michel
Introduction: The importance of this research lies in the determination of the prognostic factors that predict the clinical course of amputations in people with diabetes mellitus type 2 (DM2), the identification of these factors are of great interest for secondary and tertiary prevention of complications in DM2. Objective: To determine the main prognostic factors for the development of amputations in people with DM2.
Material and Methods: A matched case-control study with a ratio of 1: 1 was carried out, with a total of 268 people diagnosed with DM2 included in the study, of whom 134 were cases (of DM2 with amputation) and 134 were controls (DM2 without amputation). The analysis of the relationship between risk factors and amputations was made through the measure of association Odds Ratio (OR) and developing a predictive model with the main prognostic factors for the development of amputations.
Results: It was demonstrated that HbA1c greater than 8% is the main prognostic factor for the development of the pathologies that lead to amputations, such as the presence of ulcers in lower limbs (OR of 2.8, p of 0.00), the presence of diabetic neuropathy (OR of 3.6, p of 0.01) and peripheral arterial disease (PAD) (OR of 2.5, p of 0.05).
Conclusion: The main prognostic factors identified for the development of amputations in people with DM2 are the increase in HbA1c greater than 8%, the history of ulcers, PAD and diabetic neuropathy. For the prevention of amputations and the main pathologies that lead to the development of these, metabolic control is essential through an adequate control of HbA1c levels.