scholarly journals Current Aspects in the Pathophysiology and Treatment of Chronic Wounds in Diabetes Mellitus

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Elena Tsourdi ◽  
Andreas Barthel ◽  
Hannes Rietzsch ◽  
Andreas Reichel ◽  
Stefan R. Bornstein
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Chronic Wounds ◽  
Standard Treatment ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Severe Problem ◽  
Impaired Wound Healing ◽  
Patients With Diabetes ◽  
Extensive Debridement

Impaired wound healing is a frequent and very severe problem in patients with diabetes mellitus, yet little is known about the underlying pathomechanisms. In this paper we review the biology of wound healing with particular attention to the pathophysiology of chronic wounds in diabetic patients. The standard treatment of diabetic ulcers includes measures to optimize glycemic control as well as extensive debridement, infection elimination by antibiotic therapy based on wound pathogen cultures, the use of moisture dressings, and offloading high pressure from the wound bed. In this paper we discuss novel adjuvant therapies with particular reference to the use of autologous skin transplants for the treatment of diabetic foot ulcers which do not respond to standard care.

scholarly journals The Treatment of Impaired Wound Healing in Diabetes: Looking among Old Drugs

2020 ◽  
Vol 13 (4) ◽  
pp. 60 ◽  
Author(s):  
Simona Federica Spampinato ◽  
Grazia Ilaria Caruso ◽  
Rocco De Pasquale ◽  
Maria Angela Sortino ◽  
Sara Merlo
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Negative Consequences ◽  
Impaired Wound Healing ◽  
Patients With Diabetes ◽  
Reparative Process ◽  
Dipeptidylpeptidase 4 ◽  
Therapeutic Alternatives ◽  
Near Future ◽  
Old Drugs

Chronic wounds often occur in patients with diabetes mellitus due to the impairment of wound healing. This has negative consequences for both the patient and the medical system and considering the growing prevalence of diabetes, it will be a significant medical, social, and economic burden in the near future. Hence, the need for therapeutic alternatives to the current available treatments that, although various, do not guarantee a rapid and definite reparative process, appears necessary. We here analyzed current treatments for wound healing, but mainly focused the attention on few classes of drugs that are already in the market with different indications, but that have shown in preclinical and few clinical trials the potentiality to be used in the treatment of impaired wound healing. In particular, repurposing of the antiglycemic agents dipeptidylpeptidase 4 (DPP4) inhibitors and metformin, but also, statins and phenyotin have been analyzed. All show encouraging results in the treatment of chronic wounds, but additional, well designed studies are needed to allow these drugs access to the clinics in the therapy of impaired wound healing.

scholarly journals The potential of human induced pluripotent stem cells for modelling diabetic wound healing in vitro

2018 ◽  
Vol 132 (15) ◽  
pp. 1629-1643 ◽  
Author(s):  
Patricia E. Martin ◽  
Erin M. O’Shaughnessy ◽  
Catherine S. Wright ◽  
Annette Graham
Keyword(s):  
Stem Cells ◽  
Wound Healing ◽  
Induced Pluripotent Stem Cells ◽  
Pluripotent Stem Cells ◽  
Chronic Wounds ◽  
Healing Process ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Induced Pluripotent

Impaired wound healing and ulceration caused by diabetes mellitus, is a significant healthcare burden, markedly impairs quality of life for patients, and is the major cause of amputation worldwide. Current experimental approaches used to investigate the complex wound healing process often involve cultures of fibroblasts and/or keratinocytes in vitro, which can be limited in terms of complexity and capacity, or utilisation of rodent models in which the mechanisms of wound repair differ substantively from that in humans. However, advances in tissue engineering, and the discovery of strategies to reprogramme adult somatic cells to pluripotency, has led to the possibility of developing models of human skin on a large scale. Generation of induced pluripotent stem cells (iPSCs) from tissues donated by diabetic patients allows the (epi)genetic background of this disease to be studied, and the ability to differentiate iPSCs to multiple cell types found within skin may facilitate the development of more complex skin models; these advances offer key opportunities for improving modelling of wound healing in diabetes, and the development of effective therapeutics for treatment of chronic wounds.

Use of Clinical Laboratory Parameters to Evaluate Wound Healing Potential in Diabetes Mellitus

2002 ◽  
Vol 92 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Patricia L. Abu-Rumman ◽  
David G. Armstrong ◽  
Brent P. Nixon
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Renal Function ◽  
Protein Synthesis ◽  
Immune System ◽  
High Risk ◽  
Elderly Patients ◽  
Chronic Wounds ◽  
Clinical Laboratory ◽  
Patients With Diabetes

Clinicians caring for chronic wounds can easily overlook nutritional status. Patients with diabetes are at high risk for primary and secondary malnutrition. Although profiles exist defining the extent of the deficiency, the process of wound healing and the interactions of the macronutrients and micronutrients necessary to accomplish it must first be understood. In elderly patients with diabetes, additional factors such as liver and renal function, the interdependence of the immune system, and protein synthesis, also must be considered. This article provides a practical format to assist clinicians in better evaluating this often difficult-to-assess area of care. (J Am Podiatr Med Assoc 92(1): 38-47, 2002)

scholarly journals Prima Krim sebagai Solusi Penyembuh Luka pada Penderita Diabetes Meli

2019 ◽  
Vol 37 (1) ◽  
pp. 80
Author(s):  
Rahmad Dwi Ardhiansyah ◽  
Riefky Pradipta Baihaqie ◽  
Muhammad Nuriy Nuha Naufal ◽  
Muhamad Atabika Farma Nanda ◽  
Kurnia Rahmawati ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
International Diabetes Federation ◽  
Diabetic Rat ◽  
Diabetic Patients ◽  
Histopathologic Examination ◽  
Animal Blood ◽  
Number Of Patients

Number of patients with diabetes mellitus are very large, according to International Diabetes Federation (IDF) in 2013 reaches 382 billion people between the ages of 40-59 years. Diabetic has been characterized as a chronic wounds. The animal blood waste from a slaugther house is still untapped, containing PRP (Platelet Rich Plasma) that can accelerates heal of bone and soft tissue. PRP (Platelet Rich Plasma) was made from the cattle blood waste using centrifugation. The purpose of the study is to prove that the Prima cream can heal the wounds in diabetic patients. Animals used in this study is 20 Wistar rats. Induction of diabetes was using streptozootocin 65 mg/kg and nicotinamide 235 mg/kg. The animal were divided into 4 groups: non-diabetes given placebo (ND-), diabetes given placebo (DM-), diabetic rat given commercial drug were containing chloramphenicol base 20 mg + prednisolone 2.5 mg (DM+), and diabetes given cream PRP at 20% concentration (DM PRP). Parameters used to measure the rate of wound healing is wound size and histopathologic examination. The data were analyzed using Anova One Way at 95% significant rate. PRP DM group had a wound healing faster than ND- group, DM- and DM+. Based on histopathologic examination, such as epitelialization, basal membrane, fibroblasts, collagen tissue, and presence of inflammatory cells, the best curing reaction was showed in DM PRP. PRP 20% cream produces from cow blood waste can accelerate wound healing in diabetes mellitus.

scholarly journals Lupeol, a Dietary Triterpene, Enhances Wound Healing in Streptozotocin-Induced Hyperglycemic Rats with Modulatory Effects on Inflammation, Oxidative Stress, and Angiogenesis

2019 ◽  
Vol 2019 ◽  
pp. 1-20 ◽  
Author(s):  
Fernando Pereira Beserra ◽  
Ana Júlia Vieira ◽  
Lucas Fernando Sérgio Gushiken ◽  
Eduardo Oliveira de Souza ◽  
Maria Fernanda Hussni ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Inflammatory Cell ◽  
Chronic Wounds ◽  
Treated Group ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Collagen Iii ◽  
Wound Healing Activity ◽  
Immunohistochemical Analyses

Impaired wound healing is a debilitating complication of diabetes that leads to significant morbidity, particularly foot ulcers. Natural products have shown to be effective in treating skin wounds. Lupeol is known to stimulate angiogenesis, fibroblast proliferation, and expressions of cytokines and growth factors involved in wound healing. The study is performed to evaluate the wound healing activity of lupeol in streptozotocin-induced hyperglycemic rats by macroscopical, histological, immunohistochemical, immunoenzymatic, and molecular methods. Percentage of wound closure and contraction was increased in the lupeol-treated group when compared to the Lanette group. Histopathological observation revealed decreased inflammatory cell infiltration and increased proliferation of fibroblasts, vascularization, and deposition of collagen fibers after lupeol treatment. Immunohistochemical analyses showed decreased intensity of NF-κB and increased intensity of FGF-2, TGF-β1, and collagen III. ELISA results revealed downregulated IL-6 levels and upregulated IL-10 levels in response to lupeol. The mRNA expression levels of Hif-1α, Sod-2, and Ho-1 were significantly increased in response to lupeol as compared to Lanette whereas Nf-κb and Vegf-A levels were decreased in relation to insulin and lupeol treatment. These findings indicate that lupeol possesses wound healing potential in hyperglycemic conditions and may be useful as a treatment for chronic wounds in diabetic patients.

scholarly journals Verbascoside Protects Gingival Cells against High Glucose-Induced Oxidative Stress via PKC/HMGB1/RAGE/NFκB Pathway

Antioxidants ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1445
Author(s):  
Pei-Fang Hsieh ◽  
Cheng-Chia Yu ◽  
Pei-Ming Chu ◽  
Pei-Ling Hsieh
Keyword(s):  
Oxidative Stress ◽  
Wound Healing ◽  
High Glucose ◽  
Inhibitory Effect ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Stress Indicator ◽  
Patients With Diabetes ◽  
Nfκb Pathway ◽  
Oral Wound Healing

Impaired wound healing often occurs in patients with diabetes and causes great inconvenience to them. Aside from the presence of prolonged inflammation, the accumulation of oxidative stress is also implicated in the delayed wound healing. In the present study, we tested the effect of verbascoside, a caffeoyl phenylethanoid glycoside, on the improvement of cell viability and wound healing capacity of gingival epithelial cells under high glucose condition. We showed that verbascoside attenuated the high glucose-induced cytotoxicity and impaired healing, which may be associated with the downregulation of oxidative stress. Our results demonstrated that verbascoside increased the activity of the antioxidant enzyme SOD and reduced the oxidative stress indicator, 8-OHdG, as well as apoptosis. Moreover, verbascoside upregulated the PGC1-α and NRF1 expression and promoted mitochondrial biogenesis, which was mediated by suppression of PKC/HMGB1/RAGE/NFκB signaling. Likewise, we showed the inhibitory effect of verbascoside on oxidative stress was via repression of PKC/HMGB1/RAGE/NFκB activation. Also, our data suggested that the PKC-mediated oxidative stress may lead to the elevated production of inflammatory cytokines, IL-6 and IL-1β. Collectively, we demonstrated that verbascoside may be beneficial to ameliorate impaired oral wound healing for diabetic patients.

scholarly journals NETosis contributes to the pathogenesis of diabetes and its complications

2020 ◽  
Vol 65 (4) ◽  
pp. R65-R76 ◽  
Author(s):  
Rachel Njeim ◽  
William S Azar ◽  
Angie H Fares ◽  
Sami T Azar ◽  
Hala Kfoury Kassouf ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cell Death ◽  
Diabetic Kidney Disease ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Glucose Levels ◽  
Patients With Diabetes

NETosis, a novel form of neutrophil-related cell death, acts as a major regulator of diabetes and diabetes-associated complications. In this review, we show that the extrusion of neutrophil extracellular traps, termed NETs, plays an important role in the pathogenesis of type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and diabetes-induced complications. In T1DM, β-cell death induces the sequestration of neutrophils in the pancreas and seems to be correlated with increased NETosis. In T2DM patients, products of NETs release are significantly elevated. Increased levels of dsDNA are correlated with the presence of cardiovascular disease and diabetic kidney disease, further supporting the role of NETosis in the pathogenesis of other diabetes-induced complications such as impaired wound healing and diabetic retinopathy. NETosis is induced by high glucose through incompletely understood mechanisms, but it also appears to be elevated in patients with diabetes who have tightly controlled glucose levels. We hypothesize that hyperglycemia worsens the already elevated baseline of NETosis in diabetic patients to further increase its detrimental effects.

scholarly journals Comparative analysis of the effectiveness of the oral mucosa traumatic lesion treatment in patients with a comorbidity

2021 ◽  
Vol 26 (3) ◽  
pp. 229-233
Author(s):  
Yu. A. Makedonova ◽  
S. V. Poroyskiy ◽  
L. M. Gavrikova ◽  
О. Yu. Afanaseva ◽  
S. V. Dyachenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Comparative Analysis ◽  
Oral Mucosa ◽  
Healing Process ◽  
Treatment Protocol ◽  
Wound Healing Process ◽  
Impaired Wound Healing ◽  
Traumatic Lesion ◽  
Patients With Diabetes

Relevance. Patients with diabetes are prone to complications which negatively affect their quality of life. In such patients, several comorbidities may develop. One of the complications of diabetes mellitus is an impaired wound healing. Oral wound healing associated with the constant chronic trauma by sharp edges of teeth and prostheses is not an exception. Such wounds are characterized by a long, persistent, sluggish process of restoring the integrity of the oral mucosa epithelium.Materials and methods. In this paper, a comparative analysis of the effectiveness of wound treatment was carried out in 52 patients with diabetes mellitus. All patients were randomized into two equal groups. In the first group of patients, wounds were treated with traditional methods of pharmacotherapy, while in the second group, the oral mucosa was exposed to ozone and ozonated oil was applied. The patients were monitored and followed up for 14 days and as the reparative function was restored. The area and depth of the wound, the nature and amount of exudate, destruction, the edges of the wound and the surrounding connective tissue were taken into account.Results. The positive wound healing process was noted in both groups during the follow-up period. However, the inclusion of the ozone therapy in the treatment protocol favored faster restoration of the epithelium integrity.Conclusion. The present data will help dentists monitor and treat the wound process, which in turn will prevent malignancy as well as improve the prognosis for patients with diabetes.

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

1985 ◽  
Vol 43 ◽  
pp. 682-683
Author(s):  
Bruce R. Pachter
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Nerves ◽  
Sudden Onset ◽  
Extraocular Muscles ◽  
Diabetic Patients ◽  
Oculomotor Palsy ◽  
Third Nerve Palsy ◽  
Patients With Diabetes ◽  
Intramuscular Nerve ◽  
Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

Short Report: The Moisture Balance with Aloe Vera Gel in Diabetic Wound Healing

2018 ◽  
Vol 1 (1) ◽  
pp. 21-23
Author(s):  
Fahrianto Selamet ◽  
Andi Mayasari Usman ◽  
Rian Adi Pamungkas
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Wound Care ◽  
Aloe Vera ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Short Report ◽  
Bacterial Reduction ◽  
Moisture Balance ◽  
Patients With Diabetes

Diabetic foot ulcer (DF) is a chronic complication of diabetes mellitus (DM), which impact on the morbidity, mortality and quality of patients’ lives.Of those patients with diabetes mellitus, approximately 15% to 25% developed to the foot ulcer. Beside has the infection and debridement of devitalized tissue downloading; the moisture imbalance becomes the factors of recalcitrant to healing. Moist wound healing is often contraindicated to the non-healable wounds. While wound care involves the debridement, bacterial reduction, and moisture balance in order to achieve the good granulation of the tissue development and adequate blood supply.

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