The implementation of unified clinical protocol (UCP) has set a target to primary care physicians (PCP) to identify the diabetic neuropathy and angiopathy, screening the risk of diabetic foot syndrome and its prevention. The aim of our research - to determine the frequency of diabetic neuropathy, the risk of diabetic foot syndrome and level of type 2 diabetes control in patients of Kyiv region in terms of implementation of new clinical protocol in type 2 diabetes management. Materials and methods. The reports of health establishments of Kiev region were analyzed and 173 patients with type 2 diabetes were examined (aged 55,13 ± 0,61 years): group 1 - observed by PCP (n=45), group 2 - by endocrinologists (n=128). Patients examination included laboratory tests of diabetes control and evaluation of the lower limbs by Neuropathy Disability Score and determination the "ankle-shoulder" index with the portable Doppler. Statistical analysis - Excel 2007, SPSS, Statistica 6.0. Results. Despite treatment, the average levels of blood glucose, HbA1c, lipidogramme exceeded target levels in patients with type 2 diabetes, indicating their lack of control. In this regard, at 7-9 years of the disease in 19.65% of patients were founeded signs of severe and in 36.42% - moderate diabetic neuropathy of the lower limbs and in 15.03% of patients - occlusion, leading to the development of diabetic foot syndrome in 9.82% of patients, and 70.52% of the patients had moderate (44.51%) or high (26.01%) risk of its development. The differences between patients of PCP and endocrinologists were not found. However, the significant decrease of neuropathy and angiopathy of lower limbs in patients with type 2 diabetes in the Kiev region and reducing the number of amputations for 2012-2014 demonstrates the positive effect of the implementation of UCP. Conclusion. The frequency of diabetic neuropathy and angiopathy of lower limbs, the number of amputations in Kiev region decreased, that indicates a positive effect of implementation of UCP, but the risk of diabetic foot syndrome in patients remains high due to inadequate control of type 2 diabetes by patients and PC physicians and specialists that require optimization.
Use of bioelectrical impedance analysis measurements in patients with diabetes. The Diabetes Control and Complications Trial Research Group
