The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Characteristics
2.2. Evaluation of Cognitive Function
2.3. Evaluation of Neuropathy and Foot Alterations
2.4. Statistical Analysis
3. Results
3.1. Characteristics of the Study Sample
3.2. Cognitive Function
3.3. Relationship between Foot Alterations and Cognitive Function
3.4. Adherence to Treatment at the Follow-Up Visit
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Cutaneous Impairment and Appearance of Feet According to the Michigan Neuropathy Screening Instrument | |
---|---|
| Nail diseases: diseases of the nail plate and tissues surrounding it. |
| Hyperkeratosis: hyperkeratosis is caused by excessive mechanical loading. The hyperkeratosis (or callus) is thickened skin leading to a further increase in the loading of the foot, often with subcutaneous hemorrhage and eventually skin ulceration. |
| Skin care and dryness (xerosis): abnormal dryness of foot tissues caused by a lack of moisture in the skin (which can be treated by emollient therapy). |
| Amputation: resection of a segment of a limb through a bone or through a joint. |
| Overload areas: (A) a mechanical stress in some areas, the response to which is usually represented by a thickened skin callus; (B) peak pressures evaluated with baropodometric platform. |
| Foot ulceration: a break in the skin of the foot that involves at least the epidermis and part of the dermis. We considered the foot ulceration in people with currently or previously diagnosed diabetes mellitus. |
| Pre ulcerative lesions: a foot lesion with a high risk of developing into a foot ulcer, such as intra- or subcutaneous hemorrhage, blister, or skin fissure not penetrating the dermis. |
Age | Mean ± SD: 70.8 ± 1.7 years (Minimum 42–Maximum 88) |
Sex | 27 male; 27 female |
Educational level: number of individuals. | Primary school: 40 Secondary school: 6 University: 1 |
Type of Diabetes | Type I: 3 individuals Type II: 44 individuals |
Years diagnosed with diabetes | Mean ± SD: 18.8 ± 1.7 years (Minimum 2–Maximum 47) |
Glycated hemoglobin (HbA1C; %) | Mean ± SE: 7.5% ± 0.2% (Minimum 5.3–Maximum 13.1) |
BMI | Mean ± SD: 27.8 ± 0.7 (Minimum 20.0–Maximum 37.9) |
Type of foot alterations | Nail diseases: 31 of 47 individuals (64.6%) Hyperkeratosis: 22 of 47 individuals (45.8%) Skin care and dryness (xerosis): 37 of 47 individuals (77.1%) Amputation: 10 of 47 individuals (20.8%) Overload areas: 23 of 47 individuals (47.9%) Foot ulceration: 5 of 47 individuals (10.4%) Pre-ulcerative lesions: 3 of 47 individuals (6.3%) |
Neuropathy score | Mean ± SD: 6.4 ± 0.4 (Minimum 2–Maximum 13) |
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Brognara, L.; Volta, I.; Cassano, V.M.; Navarro-Flores, E.; Cauli, O. The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin. Pathophysiology 2020, 27, 14-27. https://doi.org/10.3390/pathophysiology27010003
Brognara L, Volta I, Cassano VM, Navarro-Flores E, Cauli O. The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin. Pathophysiology. 2020; 27(1):14-27. https://doi.org/10.3390/pathophysiology27010003
Chicago/Turabian StyleBrognara, Lorenzo, Iacopo Volta, Vito Michele Cassano, Emmanuel Navarro-Flores, and Omar Cauli. 2020. "The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin" Pathophysiology 27, no. 1: 14-27. https://doi.org/10.3390/pathophysiology27010003