Endocrine Abstracts (2006) 11 P4

Clinical aspects of diabetic osteoarthropathy in type 1 and type 2 diabetes mellitus patients

AP Shepelkevich1 & DI Romeiko2

1Belarusia State Medical University, Minsk, Belarus; 2Minsk-sity endocrinology dispanser, Minsk, Belarus.

Aims: The clinical and radiological observation of patients with diabetic osteoarthropathy (DOAP) was carried out with the aim of determining the most significant factors in type 1 and type 2 diabetes mellitus (DM) patients.

Methods and materials: Anamnesis, clinical and radiological data were analsed in 28 DOAP patients. The patients were divided into two groups according to the type of diabetes: group 1 included 14 patients with type 1 DM (mean age 37.8±8.6 years; disease duration 21.3±11.1 years) and group 2 included 14 patients with type 2 DM (mean age 56.2±5.9 years; disease duration 11.9±9.16 years).

Results: Almost 90% of the effected patients were of working age, which is an indication of the socioeconomic consequences of DOAP. 20 patients had a painless foot trauma, 16 patients had a claw toes, 14 patients had neuroparic ulcers, 13 patients had a long loading, 3 patients had minor amputatons in anamnesis. 7 patients had different foot deformations before DOAP developing. NDS had not a statistically difference between two groups. Bone density was reduced in type 1 DM (T-score (L2-L4): −1.11±0.59; hip: −1.93±0.83) compared with type 2 DM (T-score (L2-L4): −0.38±2.95; hip: 0.17±3.87; P<0.001). Overweight had a statistically difference (P<0.001) in DM 2 (BMI 31.3±4.9) in comparison with DM1 (25.7±3.04).

Conclusions: Our results indicate that foot trauma, claw toes wearing, high mean NDS, duration DM more than 10 years are possible risk factors for DOAP. For type 1 DM patients with DOAP more specifically risk factor is reduced bone mineral density. Overweight is a possible risk factor for the development of orthoarthropathic lesions, in particular in type 2 DM.

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