Made available in DSpace on 2014-12-17T15:16:16Z (GMT). No. of bitstreams: 1 AnaTSNS_DISSERT.pdf: 1742541 bytes, checksum: 876ff103e594fa7d61ebc99b28b10c2c (MD5) Previous issue date: 2012-03-23 / Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rh?= -0,26), diabetes duration (p=0,02; rh?= -0,28) and blood pressure (p= 0,0007; rh?= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population / O diabetes melito (DM) afetava aproximadamente 171 milh?es de pessoas no mundo no ano 2000 segundo dados da Organiza??o Mundial da Sa?de (OMS). Por ser considerada uma doen?a multissist?mica o DM ? capaz de causar complica??es diversas, principalmente ?quelas relacionadas ao sistema cardiovascular. A doen?a arterial obstrutiva perif?rica (DAOP) de membros inferiores (MMII) e a polineuropatia distal diab?tica (PNDD) podem acometer o paciente diab?tico causando consequ?ncias como o p? diab?tico e eventualmente amputa??es. O objetivo principal deste estudo foi determinar a preval?ncia de DAOP e altera??es de sensibilidade em 73 pacientes diab?ticos tipo 2 (DM2) e avaliar o impacto da DAOP na qualidade de vida, n?vel de atividade f?sica e composi??o corporal desses pacientes. Para as avalia??es cl?nicas foram utilizados: o ?ndice tornozelo-braquial (ITB); testes quantitativos de sensibilidade t?til (ST, monofilamento de 10g), dolorosa (SD), vibrat?ria (SV); reflexo aquileu (RA); question?rio de qualidade de vida SF-36; question?rio de atividade f?sica habitual de Baecke e bioimped?ncia el?trica. A preval?ncia de DAOP na popula??o estudada foi de 13,7%. O ITB correlacionou-se inversamente com a idade (p=0,03; rh?= -0,26), tempo de diagn?stico referido (p=0,02; rh?= -0,28) e press?o arterial (p= 0,0007; rh?= -0,33). Foram encontrados piores ?ndices no sum?rio de sa?de f?sica do question?rio SF-36 nos pacientes diab?ticos, no entanto, a presen?a de DAOP, de magnitude predominantemente leve, n?o ocasionou altera??es significativas na qualidade de vida, composi??o corporal ou grau de atividade f?sica avaliado por question?rio. Quatorze pacientes (19,2%) apresentaram altera??es sim?tricas e bilaterais em dois ou mais testes de sensibilidade, compat?veis com o diagn?stico de NDP. Altera??es na ST, SD e SV estavam presentes em 27,3%, 24,6% 8,2% dos pacientes; respectivamente. Houve associa??o estat?stica entre os resultados da ST com o RA e principalmente com SD, denotando a import?ncia e praticidade da utiliza??o do primeiro m?todo na avali??o de rotina no DM2. Em conclus?o, a preval?ncia de DAOP em pacientes DM2 subcl?nicos foi ligeiramente maior que a apresentada na popula??o geral e compat?vel com estudos anteriores em pacientes DM. O grau de DAOP foi predominantemente leve e ainda sem repercuss?es significativas sobre a qualidade de vida ou composi??o corporal. O presente estudo mostrou que existe preval?ncia relevante tanto de DAOP quanto de PNDD em pacientes DM2 sem diagnostico pr?vio dessas comorbidades, demonstrando a necessidade de interven??es preventivas e terap?uticas precoces para a aten??o desta popula??o