Peculiarities of chronic venous insufficiency course in patients with diabetes mellitus type 2
Objectives. To determine the peculiarities of course of the lower limbs chronic venous insufficiency (CVI) in patients with type 2 diabetes mellitus (DM). Methods. 45 patients with CVI of the lower limbs have been examined, 19 patients with type 2 DM compose the main group, and 26 patients without type 2 DM – the control group. The leading clinical syndrome of CVI (edema, leg pain, varicose and trophic changes) has been assessed according to the 10-point visual analog scale (VAS). Presence and intensity of the diabetic polyneuropathy (DPN) was evaluated with the following scales: “Neuropathic Dysfunctional Account” (NDA), “Neuropathic Symptomatic Score” (NSS). All patients underwent ultrasound triplex scanning (USTS) of the veins and arteries of the lower extremities. Results. In patients with type 2 DM the severe degree of CVI was revealed. In assessing diabetic polyneuropathy (DPN) reliable differences according to the NDA and NSS scales have been detected that testify to the presence of DPN in the patients with type 2DM. The leading clinical signs in patients with type 2 DM was edematous changes (52,6%), pain syndrome – in the control group (50%). In evaluation with a visual analog scale (VAS) the edematous syndrome (5,1±1,5) and trophic changes (4,8±3,6) prevailed in the main group. In USTS of the lower limb vessels in the patients with type 2 DM inconsistency of the saphenofemoral junction and perforating veins of various locations as well as the signs of atherosclerosis of the lower limbs were found. Positive correlation between the duration of type 2 DM and the severity of CVI in patients with macroangiopathy of lower limbs has been revealed. Conclusions. Type 2 diabetes mellitus was found out to aggravate the course of chronic venous insufficiency of the lower extremities. Clinical and ultrasound features of the CVI course in patients with type 2 diabetes have been determined.