A CLINICAL REVIEW OF NINE DIABETIC FOOT PATIENTS HOSPITALIZED DURING THE PAST SEVEN YEARS CLINICAL CHARACTERISTICS, THERAPUETIC EFFECT OF PGE1 AND PROGNOSIS

• Published in: The KITAKANTO Medical Journal Vol. 42; no. 4; pp. 379 - 385
• Main Authors: KOBAYASHI, ISAO, NAKAMURA, YASUKO
• Format: Journal Article
• Language: English; Japanese
• Published: The Kitakanto Medical Society 01.07.1992
• Subjects: Complications of diabetes; Diabetic foot; Diabetic gangrene; Prognosis with diabetic foot; Prostaglandin E1
• ISSN: 0023-1908; 1883-6135
• DOI: 10.2974/kmj1951.42.379

The prevalence of diabetic foot among hospitalized diabetic patients was 0.53% during the period from 1983 to 1990, and has increased to 0.95% over the last three years. The average age and duration of diabetes in nine cases were 59 years old and 7.6 years, respectively. Most of the patients had poorly controlled levels of blood glucose before admission, but four out of the nine patients showed fairly well-controlled levels and had HbA1C values below 9.0%. Half of these fairly well-controlled patients had bullous lesions on their feet suspected to be bullosis diabeticorum. Localization of the lesions was mostly on the toes, then soles and external malleolus of the feet. Staphylococcus aureus was most frequently cultured from the lesions and, recently, methicillin-resistant strains of Staphylococcus aureus have been cultured. All of the patients had complications including neuropathy, retinopathy and nephropathy. Neuropathy was the most frequent complication seen with diabetic foot. Intravenous administration of prostaglandin E1 had a potent effect in treatment of the ulcer-type of gangrene, but had no beneficial effect on the ishemic-type of gangrene in our cases. Of these cases, 77.8% were healed by PGE1 treatment. By January of 1991, four subjects had died from heart failure, cancer, or sepsis. Three out of the four had recurrent the lesions and all had died within five years of the appearance of their first lesion.