Functional assessment of feet of patients with type II diabetes

• Published in: Revista brasileira em promoção da saúde = Brazilian journal in health promotion 2015-08, Vol.26 (4)
• Main Authors: Cardoso, Vinicius Saura, Magalhães, Alessandra Tanuri, da Silva, Baldomero Antônio Kato, da Silva, Cristiano Sales, Gomes, Dandara Beatriz Costa, Silva, Jefferson Carlos Araujo
• Format: Article
• Language: English
• Subjects: Complicaciones de la Diabetes; Complicações do Diabetes; Diabetes Complications; Diabetes Mellitus; Diabetic Neuropathies; Neuropatias Diabéticas; Neuropatías Diabéticas
• ISSN: 1806-1222

Objective: To evaluate the incidence of functional changes and risk of developing ulcers in type II diabetic patients seen in Primary Healthcare Units (Unidades Básicas de Saúde - UBS). Methods: A cross-sectional, quantitative and descriptive study comprising 80 patients with type II diabetes mellitus (DM) aged between 41 to 85 years and attended in the PHU in the city of Parnaíba-PI. Volunteers responded to the identification form and the Michigan Neuropathy Screening Instrument (MNSI), followed by an evaluation of the lower limbs, as follows: achilles and patellar reflex, palpation of arterial pulses (dorsalis pedis and posterior tibial), tactile sensitivity (Monofilament 10g) and vibration sensitivity (128 Hz tuning fork); identification of the presence of changes such as ingrown toenails, calluses, claw toes and hair loss. Finally, using the information acquired from the assessment, subjects were classified according to the risk of developing wounds. Results: The sample consisted of 76 diabetic patients, with average age of 63.8 ± 10.4 years, 63 (82.8%) were female, mean diagnostic time 8.8 ± 7.2 years, average body mass index (BMI) 28.2 ± 5.4 kg/m2, with 15.7% of the sample being smokers. The myotatic reflexes and arterial pulses were reduced. Tactile sensitivity was identified in 81.5% and 13.1% did not feel the vibration of the tuning fork. The most dominant changes identified were calluses, 76.3% (n = 58). Risk level 2 of developing ulcers stood out, 52.6% (n = 40). Conclusion: Functional changes were detected in the sample and a classification of risk 2 for developing wounds was found in more than 50% of the assessed patients. Objetivo: Avaliar a ocorrência de alterações funcionais e o risco de desenvolver úlceras nos pacientes diabéticos tipo II atendidos em Unidades Básicas de Saúde (UBS). Métodos: Realizou-se estudo transversal, quantitativo e descritivo com 80 portadores de diabetes mellitus (DM) tipo II que apresentavam idade entre 41 e 85 anos e frequentavam as UBS do município de Parnaíba-PI. Os voluntários responderam ao questionário de identificação e ao Michigan Neuropathy Screening Instrument (MNSI), seguido da avaliação dos membros inferiores, sendo: reflexos aquileu e patelar; palpação dos pulsos arteriais (tibial posterior e pedioso); sensibilidade tátil (monofilamento 10g) e vibratória (diapasão 128 Hz); identificação da presença de alterações como unha encravada, calosidades, dedos em garra e queda de pelos. Por fim, utilizando as