Abstract
The incidence of diabetic gangrene is relatively uncommon in Japan. This paper deals with six patients with diabetic gangrene at the Hospital of the University of Nagoya and a review of 243 Japanese cases. The clinical picture of diabetic gangrene was follows:
1) In recent years this disorder has been reported with increasing frequency.
2) Three quarters of the patients were over the age of fifty, ranging from twenty to eighty years. Males predominated over females by a ratio of 2 to I.
3) In the majority of the cases, the duration of diabetes was over five years, ranging from newly diagnosed to 40 years. In eight cases the diagncsis of diabetes was made when the patients presented foot lesions.
4) Pred.sv.osing causes of this disease were burns, nailcut, trauma and trichophytosis etc.
5) In a high proportion of the patients (82%) fasting blood sugar was over 140mg/dl.
6) he most impressive was the frequent occurrence of an associated involvement of diabetic retinopathy (74%), nephropathy (61%) and coronary sclerosis (55%).
7) The majority of the patients (86%) had advanced diabetic neuropathy. These included pain, paresthesias, sensory impairment, weak or absent tendon reflexes and atonic bladder.
These results showed that diabetic angiopathy could play the most important part in the causation of diabetic gangrene, although the contribution of other various factors (e.g. infections and neuropathy) could not be excluded.
