Marchenko O. The influense of social factors on the consequences jf treatment and the course of diabetic foot syndrome

The dissertation is devoted to solving the urgent problem of endocrinology – to improve the results of treatment of patients with diabetic foot syndrome by studying the influence of social factors on the course, treatment and quality of life. In the dissertation at the modern scientific and methodological level new data on the contribution of various risk factors to the development of diabetic foot syndrome and prognostically unfavorable course of ulcerative defect are obtained. For the first time the analysis of the structure of patients with diabetes mellitus with diabetic foot syndrome, who were hospitalized in the surgical departments of a particular region, estimated the duration and peculiarity of their treatment, identified the main reasons for ineffective conservative treatment of ulcerative foot defects in the prehospital stage. For the first time the influence of social factors in the development and course of diabetic foot syndrome was determined. For the first time, self-assessment of self-health of patients with diabetic foot syndrome, analysis of its change by time factor in relation to the treatment process. Social and modified risk factors influencing the occurrence and course of ulcerative defects of the feet have been studied. The greatest risk of diabetic foot syndrome amputation has been found to be associated with foot deformity. The patient's complementarity index less than six points increases the risk by 2.3 times, the presence of amputation or ulcer in the anamnesis is accompanied by an increase in risk of 1.9 and 1.7 times, respectively. The development of diabetic foot syndrome is influenced by age, social status of the patient, duration of diabetes, the presence of diabetic angiopathy and atherosclerosis of the vessels of the lower extremities, and its course – the progression of diabetic angiopathy of the lower extremities, atherosclerosis and thrombosis of the veins of the lower extremities and lower extremities. The development and course of diabetic foot syndrome are not significantly affected by the presence of obesity and dyslipidemia in a patient with diabetes. The frequency of diabetic foot syndrome in men (37.5%) is 1.6 times higher than in women (24.0%). The social status of patients, the presence of cardiovascular complications of diabetes and comorbidities negatively affect the feasibility, adequacy and effectiveness of treatment of diabetes and comorbidities, and affects the treatment of patients (increasing the proportion of patients on insulin therapy from 37.7% to 53.3% due to a decrease in the proportion of patients on oral hypoglycemic therapy from 86.7% to 79.9%), the frequency of surgical interventions on the heart and blood vessels (increase in the proportion of patients who underwent surgery, from 4.1% to 23.3%).