scholarly journals Incidence of bullosis diabeticorum - a controversial cause of chronic foot ulceration

2008 ◽  
Vol 5 (4) ◽  
pp. 591-596 ◽  
Author(s):  
Kirsten Larsen ◽  
Tonny Jensen ◽  
Tonny Karlsmark ◽  
Per E Holstein
Keyword(s):  
Foot Ulceration ◽  
Bullosis Diabeticorum

scholarly journals Development and validation of a clinical prediction rule for development of diabetic foot ulceration: an analysis of data from five cohort studies

2021 ◽  
Vol 9 (1) ◽  
pp. e002150
Author(s):  
Francesca M Chappell ◽  
Fay Crawford ◽  
Margaret Horne ◽  
Graham P Leese ◽  
Angela Martin ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Secondary Care ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Initial Assessment ◽  
Validation Dataset ◽  
Benefit Analysis ◽  
Clinical Prediction ◽  
Net Benefit ◽  
Foot Ulceration

IntroductionThe aim of the study was to develop and validate a clinical prediction rule (CPR) for foot ulceration in people with diabetes.Research design and methodsDevelopment of a CPR using individual participant data from four international cohort studies identified by systematic review, with validation in a fifth study. Development cohorts were from primary and secondary care foot clinics in Europe and the USA (n=8255, adults over 18 years old, with diabetes, ulcer free at recruitment). Using data from monofilament testing, presence/absence of pulses, and participant history of previous ulcer and/or amputation, we developed a simple CPR to predict who will develop a foot ulcer within 2 years of initial assessment and validated it in a fifth study (n=3324). The CPR’s performance was assessed with C-statistics, calibration slopes, calibration-in-the-large, and a net benefit analysis.ResultsCPR scores of 0, 1, 2, 3, and 4 had a risk of ulcer within 2 years of 2.4% (95% CI 1.5% to 3.9%), 6.0% (95% CI 3.5% to 9.5%), 14.0% (95% CI 8.5% to 21.3%), 29.2% (95% CI 19.2% to 41.0%), and 51.1% (95% CI 37.9% to 64.1%), respectively. In the validation dataset, calibration-in-the-large was −0.374 (95% CI −0.561 to −0.187) and calibration slope 1.139 (95% CI 0.994 to 1.283). The C-statistic was 0.829 (95% CI 0.790 to 0.868). The net benefit analysis suggested that people with a CPR score of 1 or more (risk of ulceration 6.0% or more) should be referred for treatment.ConclusionThe clinical prediction rule is simple, using routinely obtained data, and could help prevent foot ulcers by redirecting care to patients with scores of 1 or above. It has been validated in a community setting, and requires further validation in secondary care settings.

scholarly journals Cognitive Impairment in People with Diabetes-Related Foot Ulceration

2021 ◽  
Vol 10 (13) ◽  
pp. 2808
Author(s):  
Ranita Siru ◽  
Melanie S. Burkhardt ◽  
Wendy A. Davis ◽  
Jonathan Hiew ◽  
Laurens Manning ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Sex Education ◽  
Foot Ulcer ◽  
Screening Tests ◽  
Community Settings ◽  
Foot Ulceration ◽  
Complex Diabetes ◽  
State Examination

Aims: To determine whether there is an excess of cognitive impairment in patients with type 2 diabetes and foot ulceration. Methods: 55 patients with type 2 diabetes and foot ulcers attending Multidisciplinary Diabetes Foot Ulcer clinics (MDFU cohort) were compared with 56 patients with type 2 diabetes attending Complex Diabetes clinics (CDC cohort) using commonly used screening tests for cognitive impairment (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA)), as well as foot self-care, mood and health literacy. MMSE was also compared between the MDFU cohort and a historical community-based cohort of patients with type 2 diabetes (FDS2 cohort). Results: Median MMSE scores were the same in all three groups (28/30). Median MOCA scores did not differ between the MDFU and CDC cohorts (25/30). There were no significant differences in the percentages of patients with MMSE ≤ 24 or MOCA ≤ 25 between MDFU and CDC cohorts (3.6% versus 10.7%, p = 0.27 and 56.4% versus 51.8%, p = 0.71, respectively), findings that did not change after adjustment for age, sex, education, diabetes duration, and random blood glucose. Conclusions: Using conventionally applied instruments, patients with type 2 diabetes and foot ulceration have similar cognition compared with patients without, from either hospital-based clinic or community settings.

scholarly journals Rocker outsole shoe is not a threat to postural stability in patients with diabetic neuropathy

2014 ◽  
Vol 40 (2) ◽  
pp. 224-230 ◽  
Author(s):  
Banafshe Ghomian ◽  
Mojtaba Kamyab ◽  
Hassan Jafari ◽  
Mohammadebrahim Khamseh ◽  
Aoife Healy
Keyword(s):  
Diabetic Neuropathy ◽  
Response Latency ◽  
Postural Stability ◽  
Response Strength ◽  
Diabetic Patients ◽  
Foot Ulceration ◽  
Objective Evidence ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Force Displacement

Background: Rocker outsole shoes are commonly prescribed to patients with diabetic neuropathy to offload a particular area of the foot sole, thereby decreasing the risk of foot ulceration. Contrary to this, some evidence has reported a postural destabilising effect of these shoes in healthy adults. Objective: To explore the postural stability of patients with diabetic neuropathy who wear a rocker outsole shoe. Study design: Quasi-experimental. Method: In total, 17 patients with diabetic neuropathy (aged 49.29 ± 7.48 years; 7 female, 10 males) participated in this study. A Motor Control Test measuring centre of force displacement, response strength scale and response latency in medium and large perturbations was conducted using the EquiTest system to evaluate postural stability while wearing a baseline shoe (without a rocker outsole) or a rocker outsole shoe (with a toe-only rocker sole). Results: No significant difference was observed between the shoe conditions in centre of force displacement and response latency of the participants (p > 0.05). The results indicated a significant increase in the response strength scale of participants by the rocker outsole, for medium forward and backward and large forward perturbations ( p = 0.014, p = 0.001 and p = 0.027, respectively). Conclusion: When the immediate effect is a concern, the rocker outsole shoe did not negatively affect postural stability in patients with diabetic neuropathy. Clinical relevance This article will provide objective evidence about the effect of rocker outsole on postural balance in diabetic patients. In prescription of rocker outsole to prevent plantar ulceration of diabetic foot, immediate postural destabilising is not a concern.

scholarly journals Importance of Time Spent Standing for Those at Risk of Diabetic Foot Ulceration

Diabetes Care ◽  
2010 ◽  
Vol 33 (11) ◽  
pp. 2448-2450 ◽  
Author(s):  
B. Najafi ◽  
R. T. Crews ◽  
J. S. Wrobel
Keyword(s):  
At Risk ◽  
Diabetic Foot ◽  
Foot Ulceration
Sign in / Sign up

Export Citation Format

Share Document