A REVIEW ON ASSOCIATION OF LOWER LIMB COMPLICATIONS AND CANCER RISK RELATED TO TYPE 2 DIABETES

Abstract

Lower limb complications associated with diabetes are peripheral sensory neuropathy and peripheral artery diseases. Amputation risk increases with diabetes and mostly happens in the lower limb. Disabilities occur due to lower limb complications which then affect patients' health and social lives. Diabetes is associated with other diseases like cardiovascular issues, cancer, etc. Death risk in diabetes type 2 patients having lower limb complications is highly associated with cancer. When the interaction between peripheral neuropathy and peripheral artery diseases (PAD) with cancer death risk is measured, it showed a high association with PAD having a hazard ratio of 8.9 and peripheral neuropathy patients having a hazard ratio of 8.4. Among them, lower limb arterial thrombosis is highly associated with all cancer deaths. Lower-extremity complications are the leading cause of macrovascular and microvascular diseases. Other minor risk factors linked with lower limb complications are age, smoking, and obesity. The risk of lower limb complications and cancer is prevalent among smokers as compared to non-smokers. However, there is no particular study on this factor. Lower-limb malignancies are associated with many biological disorders like increased glycation end products, chronic inflammation, and oxidative stress. In one study, cancer risk was measured among various diabetic patients having lower limb complications. The results showed less cancer death risk among the group of patients having proper glucose level and blood pressure level controls. Among all the cancers affecting diabetic patients, almost 4% are melanoma which if misdiagnosed during early stages due to various reasons can lead to biopsy. Acral melanoma is usually misdiagnosed in up to 40% of cases. The purpose of a biopsy is the diagnosis of the problem as well as the prediction of the exact stage of melanoma.