Suivi d'une cohorte de patients diabétiques à risque podologique et étude de l'évolutivité de leur neuropathie

Foot lesions in diabetic patients with neuropathy are a management problem to avoid the risk of amputation. A regular podiatric monitoring is proposed in France. We prospectively followed a cohort of patients at high risk of foot problems to better analyse the impact of an educational monitoring program, and to evaluate the potential evolution of neuropathy. 134 patients were enrolled; 68 of them were regularly followed to strengthen monitoring and education for 33±25 months, while others were followed over 18 months. None of the patients in the first group has been amputated vs. 5 amputations in the other group. The regular monitoring and strengthening education save 10% of amputations (P <0.02). At baseline 25.0% of patients had a visual and 20.9% a motor disability, which reduce the self-monitoring of their feet. The systematic measurement of vibration perception thresholds shows in patients enrolled with a 15 volts threshold, that his value can deteriorate in a few months for reaching a 25 volts level, with consequently an increased risk of diverse foot problems and lesions.