Supervisors info:
Τεντολούρης Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Κόκκινος Αλέξανδρος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μακρυλάκης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
The first effort for the comprehension of diabetes mellitus has been recorded 3500 years ago in the Human History, and for a very good reason. Diabetes mellitus is an extremely frequent disease, accompanied by high morbidity and mortality, especially before the wide use of insulin and new pharmaceutical agents. As it is, diabetes mellitus affects over 460 million people in the world and a significant rise is expected in the years to come.
The present thesis strives to elucidate certain aspects of diabetes mellitus pathophysiology, specifically those which contribute to the vascular injury and result in the diabetic foot formation.
During the general part of the study, the effect of the pancreatic β-cells malfunction is described and also how this process gradually leads to raised insulin resistance. What is more, certain aminoacids are mentioned, the high concentration of which seems to precede diabetes development, and also of some other agents, genetic and non-genetic, which traditionally correlate with diabetes mellitus emergence such as gestation, schizophrenia and depression. Moreover, the major epidemiological factors are mentioned and also the updated definition and diagnostic criteria of diabetes mellitus, according to the Hellenic Diabetes Association’s guidelines.
An attempt is performed for an as much as possible deeper reference and analysis of the factors that contribute to the microvascular and macrovascular complications’ development of diabetes mellitus, such as high oxidative stress, the polyoles’ path activation, the AGEs’ effect, the protein kinase pathway and the hexosamine C activation.
Also, the definition of the diabetic foot is given and its pathophysiology is outlined with reference to its clinical spectrum and the underlying microbiology.
In the special part, the purpose of our studies analyzed which is the recording of patients attended by the Diabetic Foot Outpatient Clinic of the National and Kapodistrian University of Athens regarding the diabetic foot ulcers and concomitant cardiovascular disease risk factors and smoking habits.
Subsequently, the results of our statistical analysis are referenced with citation of the emergent descriptive model and of the analytical parameters.
According to our study, we note that diabetic foot patients bear higher probability for worse outcome of their disease if they also suffer from hypertension and if they are active or past smokers. Also, higher probability for worse outcome bear the patients who suffer from microvascular complication or from both microvascular and macrovascular complications.
We hope that our conclusions may provide more information regarding the effect of cardiovasculary disease risk factors in diabetic foot patients in order to achieve a more effective and holistic approach in the future
