山陰地方における糖尿病性壊疽について10例の観察

抄録

The San-in Area is located in the western part of Japan and faces to the Japan Sea where the weather is cold and damp in winter. In this area, diabetic gangrene seems to be more frequent than in other parts of Japan. Since 1969, ten patients with diabetic gangrene have been treated at our clinic. The clinical findings of these ten patients are summarized as follows:
1) Among the 469 diabetic patients treated between October 1969 and April 1972, at the First Department of Internal Medicine of the Tottori University School of Medicine, 10 cases suffered from gangrene of the lower extremities. The incidence amounted to 2.13%. The ages ranged from 21 to 72 (average 52.9).
2) There was no significant difference in incidence between the sexes; six cases of diabetic gangrene were found among the 277 males (2.16%), and 4 cases among the 192 females (2.08%).
3) All of the patients with diabetic gangrene were suffering from diabetes unsatisfactorily treated over long periods.
4) In all cases, the pulses of the A. dorsalis pedis were palpable and these gangrenes appeared as “spotty” lesions. In all cases, the walls of the small vessels of the skin obtained by biopsy were positively stained with PAS.
5) Low temperatures, rubber shoes, and moxibustion tended to render diabetics in this area more prone to the development of gangrene of the lower extremities.
6) Diabetic retinopathy, neuropathy, and/or nephropathy were found in high incidence among the 10 patients with diabetic gangrene.