Duration of Type II DM, HbA1C Levels, TNF-α and IL-10 as Risk Factors for Level Charcot Joint Foot and Ankle in Type II DM Patients

Introduction: Type II Diabetes Mellitus has complications including disorders of the musculoskeletal system or what is often called diabetic charcot joint or charcot neuroarthropathy. Various risk factors are thought to increase the incidence of Charcot joint foot and ankle. Various studies have been made to assess these risk factors with the aim of reducing the occurrence of these complications. Material and Methods: The study used an analytical observational design with a case study and control approach to determine whether Type II DM II ≥ 10 years, HbA1c levels II ≥ 7%, TNF-α levels II ≥ 1.0 ng/L and IL-10 levels ≤ 255 pg/mL as factors. risk of Charcot joint foot and ankle in Type II DM patients. Where the sample involves 24 case groups and 24 control groups. Then a descriptive analysis was performed, bivariate inferential analysis using the chi-square test and an assessment of the risk factor odds ratio (OR). Then multivariate analysis was performed to assess the strength of the influence of risk factors using logistic regression test Results: There is a significant difference between Type II DM II ≥ 10 years, HbA1c levels II ≥ 7%, TNF-α levels II ≥ 1.0 ng/L, and IL-10 levels ≤ 255 pg/mL which are risk factors for the occurrence of charcot joint foot and ankle in Type II DM patients. The duration of type II DM II ≥ 10 years had the strongest relationship while IL-10 ≤ 255 pg/mL had the weakest relationship for the occurrence of Charcot joint foot and ankle in Type II DM patients. Conclusion: Increased duration of Type II DM, HbA1c level and TNF-α level above certain level and low IL-10 amount are risk factor for Charcot joint foot and ankle in Type II DM patients, with the duration of type II DM being the strongest risk factor. Key words: Diabetes mellitus type II, charcot joint foot and ankle, risk factors.

Diagnosis and treatment of Charcot arthropathy in diabetic patients

Background: Charcot joint or neurogenic arthropathy in diabetes is a late complication invading the foot and ankle that results in dislocation, instability, and deformity of the affected area. Sensory neuropathy leads to numbness and malalignment of the foot and ankle or inadequate post-traumatic response, which results in progressive fractures, multiple joint dislocations, ulcerations, osteomyelitis, and amputation. Because of such serious consequences, understanding of pathophysiology is important in determining treatment strategies. Early diagnosis and appropriate treatment can prevent this destructive process.Current Concepts: The number of adults diabetic patients continuously increases. Health care and life expectancy will continue to improve with the development of medicine. As a result, the incidence of diabetes-related complications will increase. Diabetic Charcot joint will have a serious negative impact on the quality of life and financial burden on the diabetic patients. The goal of treatment for Charcot joint is not to build a normal foot, but to make a stable plantigrade foot that can be worn shoes. Therefore, it would be most important to understand the progress and characteristics of the disease and to develop an appropriate plan in order to select the appropriate treatment method.Discussion and Conclusion: Understanding Charcot joint and familiarization with its appropriate treatment should reduce the number of the cases of diabetic Charcot joint patients with disabilities or amputations.