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THE IMPORTANCE OF RADIOLOGICAL METHODS IN THE DIAGNOSIS OF
DIABETIC FOOT SYNDROME: A CASE STUDY FROM KHOREZM REGION
Jonibek Saparbayevich Yangibayev¹
Intizor Rajapboyevna Avazmetova²
Niginabonu Hamrobek qizi Khajiqurbanova³
¹Assistant, Department of Military Field Therapy,
Hematology and Diagnostics, Urgench Branch of the Tashkent Medical Academy
Email: jonibekyangibayev@gmail.com | ORCID: 0009-0009-4738-2118
²Associate Professor, Department of Biology,
Urgench State University named after Abu Rayhon Beruni
https://doi.org/10.5281/zenodo.15770732
Abstract:
Diabetic foot syndrome
(DFS
)
is among the most serious and common
complications of diabetes mellitus, often leading to infection, ischemia, and lower limb
amputation. The lack of a unified and accessible diagnostic protocol in regional healthcare
settings, such as the Khorezm region, significantly delays timely diagnosis and treatment. This
study aims to evaluate the effectiveness of radiological and functional diagnostic methods—
particularly transcutaneous pulse oximetry (TcpO₂) and color duplex scanning (CDS)—in
identifying and classifying DFS in 100 patients across various medical institutions. Based on
TcpO₂ levels and arterial pulsation, patients were divided into four groups, revealing that the
TcpO₂ + CDS combination provides a cost-effective, informative tool for early detection and
treatment planning. The results support the development of a simplified protocol suitable for
primary care use to reduce the risk of complications and improve patient outcomes.
Keywords
Diabetic foot syndrome, transcutaneous pulse oximetry, color duplex scanning,
diagnostic algorithm, diabetes mellitus, ischemia, Khorezm region, neuropathy, radiological
methods, early detection.
Introduction
Diabetes mellitus (DM) is currently one of the most serious public health issues globally.
According to data from the International Diabetes Federation (IDF), more than 387 million
people were diagnosed with diabetes worldwide in 2014 11. According to statistics from the
World Health Organization (WHO), approximately 4–5 million people die each year due to
complications of this disease 22. One of the most dangerous complications of diabetes is
diabetic foot syndrome (DFS), which occurs in one in five patients and leads to major lower
limb amputation in 4–6% of cases 33.
As of the end of 2024, more than 25,000 people in the Khorezm region are under
dispensary observation for DM. Of these, approximately 5,000 patients show signs of diabetic
foot syndrome. One of the key issues in the region is the lack of an early, accurate, and
systematic diagnostic algorithm.
Methods
During 2023–2024, a total of 100 patients diagnosed with DFS were monitored in
central polyclinics and the regional endocrinology dispensary in Urgench city and districts of
Khorezm region. The study was conducted based on a systematic radiological diagnostic
algorithm built on the principle of “from simple to complex.”
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The following diagnostic stages were carried out:
1.
Neuropathy assessment
— based on the Neuropathy Disability Score (NDS) developed
by M.J. Young in 1986.
2.
Assessment of arterial pulsation
— through palpation of major arteries in the foot.
3.
Transcutaneous pulse oximetry (TcpO₂)
— oxygen saturation levels were measured
on the first and fifth toes.
4.
Radiography
— performed if diabetic osteoarthropathy or soft tissue inflammation was
suspected.
5.
Color duplex scanning (CDS)
— used to assess arterial patency and blood flow.
Patients were classified into four groups based on TcpO₂ levels and the presence or
absence of arterial pulsation.
Results
Among the 100 patients examined, the following conditions were identified:
Condition Type
TcpO₂ Level
Pulse Status
Number of Patients
(%)
Critical ischemia
≤ 90%
Absent
22 (22%)
Microangiopathy
≤ 90%
Present
18 (18%)
Neurotrophic form
≥ 90%
Present
37 (37%)
Atherosclerotic
lesions
≥ 90%
Absent
23 (23%)
These findings indicate that the combination of TcpO₂ and CDS is the most informative
and cost-effective method for early detection, differential diagnosis, and treatment planning in
DFS.
Discussion
In current clinical practice in the Khorezm region, DFS is often diagnosed at later stages.
This is largely due to the diagnostic process being excluded from primary care settings and
the insufficient implementation of tomographic and functional diagnostic tools.
During the study, a simplified diagnostic protocol was developed that can be applied at
the primary care level. This approach helps in preventing the progression of the disease into
more severe forms.
Additionally, although access to advanced diagnostic technologies such as
carboxygraphy and angiography is limited in the region, algorithms based on TcpO₂ and CDS
can partially compensate for these limitations.
Conclusion
Introducing a simplified, informative, and protocol-based tomographic diagnostic
algorithm is essential for early detection of diabetic foot syndrome in the Khorezm region. An
algorithm based on transcutaneous pulse oximetry and color duplex scanning can be
effectively applied at the primary level, reduce complications, prevent amputations, and
improve patients’ quality of life.
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References:
Используемая литература:
Foydalanilgan adabiyotlar:
1.
IDF.
International
Diabetes
Federation.
URL:
http://www.idf.org/worlddiabetesday/toolkit/gp/facts-figures
2.
WHO.
Fact
sheet
on
Diabetes.
URL:
http://www.who.int/mediacentre/factsheets/fs312/ru/
3.
Stupin V.A., Rumyantsev S.A., Silina E.V. Multidisciplinary approaches to the treatment of
ischemia and hypoxia syndromes in diabetic patients. Moscow: MAIPRINT, 2011.
4.
Young M.J. et al. A scale for the assessment of neuropathy in diabetic patients.
Neurodiab, EASD, 1986.
