Pie diabético. Fisiopatología y consecuencias

Rodrigo Triana Ricci

doi:10.1016/j.rccot.2015.04.006

Autores/as

Rodrigo Triana Ricci Clínica de Occidente. Cali, Colombia

DOI:

https://doi.org/10.1016/j.rccot.2015.04.006

Palabras clave:

pie diabético, polineuropatía, necrosis, ácido tióctico, pregabalina

Resumen

Las reflexiones que se hacen en este artículo se deben al incremento de esta enfermedad. Las consideraciones que se tienen de ella desde su diagnóstico inicial son mínimas y parece que, a medida que pasa el tiempo, aumenta su prevalencia en la comunidad. Las secuelas que el pie diabético produce son devastadoras desde el punto de vista de las complicaciones médicas para el paciente, la calidad de vida, los problemas sociales, laborales y el gran costo financiero que producen.
Por lo tanto, de acuerdo con estudios anteriores donde de manera separada se nos dieron a conocer los daños producidos por la diabetes en el pie y el desarrollo de su fisiopatología, se presenta esta revisión con el objetivo de llegar a lograr una presencia cada vez mayor en estamentos universitarios y organizaciones no gubernamentales para establecer programas de salud pública para el manejo de esta patología.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Rodrigo Triana Ricci, Clínica de Occidente. Cali, Colombia

Ortopedista-traumatólogo Miembro fundador del capítulo de Infecciones Óseas. Coordinador de Ortopedia y Traumatología, Clínica de Occidente, Cali. Coordinador de Ortopedia y Traumatología, Universidad de Santiago de Cali. Magistrado del Tribunal de Ética Médica del Valle del Cauca

Referencias bibliográficas

Rosas Guzmán J, Odriozola A, Davidson JA, eds. Guía práctica en el manejo de la polineuropatía diabética Neuralad 2010.

Kahn CR, Weir GC, et al. Jodlin's Diabetes Mellitus;. Philadelphia: Lea & Fabiger; 1994. p. 300.

Pedraza L. Neurólogo Dolor neuropático. Diagnóstico Univ. Chile.

Manual Merck, 8.a edición. Barcelona: Doyma, 1989.

Gagliardino JJ. Evaluations of quality of diabetes care in Latin America. Rev Panam Salud Publica. 2001;10(5). https://doi.org/10.1590/S1020-49892001001100003

Costa Gil JE. XII Congreso Argentino de Diabetes; octubre 2002.

Olivera EM. Revista de la Sociedad Argentina de Diabetes 1992;26:41-51.

Boulton AJM. The diabetic foot: grand overview, epidemiology and pathogenesis. Diabetes Metab Res Ver. 2008;24 Suppl 1:S3-6. https://doi.org/10.1002/dmrr.833

Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293:217-28. https://doi.org/10.1001/jama.293.2.217

Brownlee M. The pathobiology of diabetic complications. Diabetes. 2005;54:1615-25. https://doi.org/10.2337/diabetes.54.6.1615

Boulton AJM, Armstrong D, Albert S, Fryberg R, Hellman R, Kirkman M, et al. ADA-AACE Task Force. Diabetes Care. 2008;31 Suppl 1:1679-85. https://doi.org/10.2337/dc08-9021

Triana R. Recomendaciones de manejo de pié diabético. Simposio sobre Pie Diabético, marzo 23-24/2012, Cali.

Martínez-De Jesús FR. A checklist system to score healing progress of diabetic foot ulcers. Int J Low Extrem Wounds. 2010;9:74. https://doi.org/10.1177/1534734610371594

Sergeev IN, Rhoten WB. 1,25-Dihydroxyvitamin D3 evokes oscillations of intracellular calcium in a pancreatic b-cell line. Endocrinology. 1995;136:2852-61. https://doi.org/10.1210/endo.136.7.7789310

Boucher BJ. Inadequate vitamin D status: does it contribute to the disorders comprising syndrome X. Br J Nutr. 1998;79:315-27. https://doi.org/10.1079/BJN19980055

Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R. The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract. 2003;57:258-61. https://doi.org/10.1111/j.1742-1241.2003.tb10480.x

Lind L, Heanni A, Litthell H, Hvarfner A, Seorensen OH, Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995;8:894-901. https://doi.org/10.1016/0895-7061(95)00154-H

Inomata S, Kadowaki S, Yamatani T, Fukase M, Fujita T. Effect of 1 alfa (OH)-vitamnin D3 on insulin secretion in diabetes mellitus. Bone Miner. 1986;1:187-92.

Zittermann A. Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr. 2003;89:552-72. https://doi.org/10.1079/BJN2003837

Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care. 2007;30:980-6.

Rev Med Chile 2010; 138: 1312-1318. Vitamina D y síndrome metabólico - M. I. Querales et al., 1318 Artículo de Revisión. https://doi.org/10.2337/dc06-1994

Mattila C, Knekt P, Männistö S, Rissanen H, Laaksonen MA, Montonen J, et al. Serum 25-Hydroxyvitamin D concentration subsequent risk of Type 2 diabetes. Diabetes Care. 2007;30:2569-70. https://doi.org/10.2337/dc07-0292

Di Cesar DJ, Ploutz-Snyder R, Weinstock RS, Moses AM. Vitamin D deficiency is more common in type 2 than in type 1 diabetes. Diabetes Care. 2006;29:174. https://doi.org/10.2337/diacare.29.01.06.dc05-1876

Becker B, Hullet D, O'Herrin J, Malin G, Sollinger H, DeLuca H. Vitamin D as immunomodulatory therapy for kidney transplantation. Transplantation. 2002;74:1204-6. https://doi.org/10.1097/00007890-200210270-00030

Lemire J, Archer D, Beck L, Spiegelber H. Immunosuppressive actions of 1,25-dihydroxyvitamin D3: preferential inhibition of Th1 functions. J Nutr. 1995;125:1704S-8S. https://doi.org/10.1016/0960-0760(95)00106-A

Long K, Santos J. Vitamins and the regulation of the immune response. Pediatr Infect Dis J. 1999;18:283-90. https://doi.org/10.1097/00006454-199903000-00018

Adorini L. Tolerogenic dendritic cells induced by vitamin D receptor ligands enhance regulatory T cells inhibiting autoimmune diabetes. Ann NY Acad Sci. 2003;987:258-61. https://doi.org/10.1111/j.1749-6632.2003.tb06057.x

Rigby W, Waugh M, Graziano R. Regulation of human monocyte HLA-DR and CD4 antigen expression, and antigen presentation by 1,25-dihidroxyvitamin D3. Blood. 1990;76:189-97. https://doi.org/10.1182/blood.V76.1.189.189

Zella J, DeLuca H. Vitamin D autoimmune diabetes. J Cell Biochem. 2003;88:216-22. https://doi.org/10.1002/jcb.10347

Bian K, Ishibashi K, Bukoski R. 1,25(OH)2D3 modulates intracellular Ca+2 and force generation in resistance arteries. Am J Physiol. 1996;270:H230-7. https://doi.org/10.1152/ajpheart.1996.270.1.H230

Krause R, Buhring M, Hopfenmuller W, Holick M, Sharma A. Ultraviolet B and blood pressure. Lancet. 1998;352:709-10. https://doi.org/10.1016/S0140-6736(05)60827-6

Li Y, Kong J, Wei M, Chen Z, Liu S, Cao L. 1,25-dihydroxyvitamin D3 is a negative endocrine regulator of rennin-angiotensin system. J Clin Invest. 2002;110:229-38. https://doi.org/10.1172/JCI0215219

Xiang W, Kong J, Chen S, Cao L, Qiao G, Zheng W, et al. Cardiac hypertrophy in vitamin D receptor Knockout mice: role of the systemic and cardiac rennin-angiotensin systems. Am J Physiol Endocrinol Metab. 2005;228:E125-32. https://doi.org/10.1152/ajpendo.00224.2004

Jespersen B, Randlow A, Abrahamsen J, Fogh-Andersen N, Olsen N, Kanstrup I. Acute cardiovascular effect of 1,25- dihydroxycholecalciferol in essential hypertension. Am J Hypertens. 1998;11:659-66. https://doi.org/10.1016/S0895-7061(98)00025-9

Hatton D, Xue H, DeMerritt H, McCarron D. 1,25-(OH)2 Vitamin D3-induced alterations in vascular reactivity in the spontaneously hypertensive rats. Am J Med Sci. 1995;269:C443-50.

Pereira M, Jacobs D, Van Horn L, Slattery M, Kartashov A, Ludwig D. Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA study. JAMA. 2002;287:2081-9. https://doi.org/10.1001/jama.287.16.2081

Fujita T, Palmieri G. Calcium Paradox disease: calcium deficiency prompting secondary hyperparathyroidism and cellular calcium overload. J Bone Miner Metab. 2000;18:109-25. https://doi.org/10.1007/s007740050101

Zemel M, Shi H, Greer B, Dirienzo D, Zemel P. Regulation of adiposity by dietary calcium. FASEB J. 2000;14:1132-8. https://doi.org/10.1096/fasebj.14.9.1132

Melanson E, Sharp T, Schneider J, Donahoo W, Grunwald G, Hill J. Relation between calcium intake and fat oxidation in adult humans. Int J Obes Relat Metab Disord. 2003;77:1448-52. https://doi.org/10.1038/sj.ijo.802202

Wehmeir K, Beers A, Haas M, et al. Inhibition of AI gene expression by 1,25-dihydroxyvitamin D3. Biochim Biophys Acta. 2005;1737:16-26. https://doi.org/10.1016/j.bbalip.2005.09.004

Ford E, Ajani U, McGuire L, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care. 2005;28:1228-30. https://doi.org/10.2337/diacare.28.5.1228

Reis J, von Mühlen D, Kritz-Silverstein D, Wingard D, Barrett-Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care. 2007;30: 1549-55. https://doi.org/10.2337/dc06-2438

Hjelmesaeth J, HofsØ D, Aasheim ET, Jenssen T, Moan J, Hager H, et al. Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study. Cardiovascular Diabetology. 2009;8:7. https://doi.org/10.1186/1475-2840-8-7

Liu S, Song Y, Ford E, Manson J, Buring J, Ridker P. Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes Care. 2005;28:2926-32. https://doi.org/10.2337/diacare.28.12.2926

Oliveri MB, Ladizesky M, Mautalen CA, Alonso A, Martínez L. Seasonal variations of hydroxyvitamin D and parathyroid hormone in Ushuaia (Argentina), the southern most city of the world. Bone Miner. 1993;20:99-108. https://doi.org/10.1016/S0169-6009(08)80041-4

Bunout D, Barrera G, Leiva L, Gattas V, de la Maza MP, Haschke F, et al. Effect of a nutritional supplementation on bone health in Chilean elderly subjects with femoral osteoporosis. J Am Coll Nutr. 2006;25:170-7. https://doi.org/10.1080/07315724.2006.10719529

De la Maza MP, Leiva L, Barrera G, Boggiano C, Herrera T, Pérez Y, et al. Evaluación a largo plazo del estado nutricional, composición corporal y densidad mineral ósea en mujeres operadas de bypass gástrico: impacto del nivel socioeconómico. Rev Med Chile. 2008;136:1415-23. https://doi.org/10.4067/S0034-98872008001100007

Pinilla AE, Fonseca GC. Pie diabético. En: Ardila E, Arteaga JM, Rueda PN, editores. Perspectivas en medicina interna. Bogotá: Unibiblos; 2000.

Armstrong DG, Lavery LA. Clinical Care of Diabetes foot. ADA. 2005:1-10.

Lobmann R, Schultz G, Lehnert H. Proteases and the diabetic foot syndrome: mechanisms and therapeutic implications. Diabetes Care. 2005;28:461-71. https://doi.org/10.2337/diacare.28.2.461

Márquez G, Escobar I, Brugués J, eds. Análisis del grupo colombiano de Colpedis para el pie diabético. Federación Diabetológica Colombiana, Guías para prevención, Diagnóstico y Tratamiento, 2007.