Tropical Diabetic Hand Syndrome in Patients with Diabetic Nephropathy

Diabetic nephropathy syndrome is a condition of dysfunction in the vascular endothelial, smooth muscle cells of the blood vessels, as well as in the renal mesangial cells. This causes the occurrence of microvascular locus ischemic and local hypoxia 2. Diabetic nephropathy slows the wound healing process of Tropical Diabetic Hand Syndrome (TDHS) which is a specific complication in the hands experienced by patients with diabetes mellitus (DM). A patient presented with type 2 DM who had complications of TDHS and diabetic nephropathy. The risk factors for TDHS in these patients are female gender, age 52 years, poor glycemic control, and delay in seeking treatment. The terminal nephropathy condition of terminal diabetes has a poor prognosis in TDHS and the sepsis complication of TDHS is a risk factor for worsening renal function in diabetic nephropathy. TDHS management includes hospitalization, elevation of the affected hand, optimal blood glucose control, antibiotics and wound care in the form of incision, debridement, and drainage, if necessary, for further surgery and other rehabilitation measures. The approach of diabetic nephropathy therapy includes diagnosis, detecting other comorbid conditions, blood glucose regulation, hypertension regulation and proteinuria, dietary regulation, and multifactorial intervention. Education for TDHS patients and diabetic nephropathy is still the most important prevention tool in developing countries.