Bagus Aulia Mahdi, - and Satyawardhana, - and Hermina Novida, - and Agil Al Jufri, - and Muhammad Zulfadly Nuralim, - and Dhihinitia Jiwangga, - and Arif Rachman, - (2021) Strategic Approach for Diabetes Mellitus Type 2 Patients with Acute Limb Ischemia and COVID-19: Is Amputation Mandatory? Case Series. Journal of Hunan University Natural Sciences, 48 (7). pp. 127-132. ISSN 1674-2974

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Abstract

Diabetes Mellitus Type 2 in COVID-19 patients accompanied by acute limb injury makes the treatment more complex. The aim of this case report is to describe the best treatment strategy for patients with diabetes mellitus type 2 with acute limb ischemia. We present two cases of patients who tested positive for COVID19 by nasopharyngeal swab with a history of diabetes mellitus type 2, With Clinical Signs Of Acute Limb ischemia. Occlusion sites of the arteries were confirmed by CT angiography in the first case, and by Doppler vascular ultrasound in the second case. Nonetheless, despite the revascularization, fine blood sugar control, and controlled COVID-19 management, amputation had to be performed since the previous attempts at treatment produced unsatisfactory results. An improvement of clinical condition after amputation was reported. Diabetes mellitus type 2 accompanied with acute limb ischemia and COVID-19 is a complex case that needs good hyperglycemic control management, comprehensive COVID-19 treatment, and immediate treatment for acute limb ischemia. Revascularization strategy appears to be insufficient, and all clinical and laboratory aspects showed promising improvement following the amputation.

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