The results of diabetic foot syndrome screening among rural patients with diabetes in Uzbekistan

Aim. To present results of combined surgical treatment of the ischemic form of diabetic foot syndrome complicated by pyonecrotic process. To show thatthe use of modern diagnostic tools and the choice of adequate treatment strategy permits to substantially reduce the number of above-the-knee amputations. Materials and methods. A total of 140 patients with diabetes mellitus and critical ischemia of lower extremities were under observation during 2004-2008.All of them had purulent and/or necrotic foot lesions. The patients were examined by X-ray, computed and magneto-resonance tomography of the feet,duplex scanning of lower leg vasculature, transcutaneous measurement of PO2, pelvic and lower leg arterial angiography. Results. A strategy of surgical treatment was developed to be used depending on the patients health status, clinical features and severity of pyonecroticprocesses in the foot, and the degree of involvement of the main blood vessels of lower extremities. Conclusion. Combination of endovascular surgery with various methods for plastic wound closure permits to extend the range of possibilities for the treatmentof high-risk patients, such as those with pyonecrotic lesions and neuroischemic form of diabetic foot syndrome. This approach opens up prospects fora significant decrease of percentage of above-the-knee amputations and improves the quality of life in these patients.

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Diabetic foot syndrome in patients with diabetes. A multicenter German/Austrian DPV analysis on 33 870 patients

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.3020 ◽

2018 ◽

Vol 34 (6) ◽

pp. e3020 ◽

Cited By ~ 11

Author(s):

Barbara Bohn ◽

Arthur Grünerbel ◽

Marcus Altmeier ◽

Carsten Giesche ◽

Martin Pfeifer ◽

...

Keyword(s):

Diabetic Foot ◽

Diabetic Foot Syndrome ◽

Patients With Diabetes

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Bubbling Treatment Option in the Complex Therapy of Diabetic Foot Syndrome

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2021-14-3-210-215 ◽

2021 ◽

Vol 14 (3) ◽

pp. 210-215

Author(s):

Anton Petrovich Ostroushko ◽

Alexander Alekseevich Andreev ◽

Alexander Alexandrovich Shmarin ◽

Vladislav Valeryevich Novomlinsky ◽

Anastasia Yurievna Laptiyova ◽

...

Keyword(s):

Treatment Option ◽

Diabetic Foot ◽

Soft Tissues ◽

Treatment Method ◽

Late Complications ◽

Diabetic Foot Syndrome ◽

Control Group ◽

Results Of Treatment ◽

Patients With Diabetes ◽

After Cancer

Diabetes mellitus (DM) is the most common and socially significant endocrine disease that leads to early disability and is the most common cause of mortality in patients after cancer and cardiovascular pathology. The cost of managing patients with diabetes can reach 30% of the country's health budget, 90% of which is spent on the treatment of its complications. Diabetic foot syndrome (DFS) is developed in 20-80% of patients and is one of the most dangerous late complications. In clinical practice, various approaches to its treatment are used, but the number of high amputation and mortality rate in this group of patients remains significant. The aim of the study was to improve the results of treatment of patients with diabetic foot syndrome (DFS) by including the bubbling treatment method in the program of therapeutic measures. Forty-eight patients with neuropathic and neuroischemic forms of DFS were treated. The control group consisted of 23 patients receiving conventional treatment, the main group included 26 patients, who were applied bubbling treatment option locally. The analysis of groups of patients showed no significant differences by gender, age, stages of diabetic foot syndrome, depth of necrotic defect, complications and concomitant diseases. The use of the bubbling treatment method in the complex treatment of patients with DFS allowed more effectively arresting symptoms of local (edema, hyperemia, wound exudate, necrolysis) and general inflammation, anemia and intoxication syndromes, contributed to the activation of regeneration processes in soft tissues, which, combined with complex FDS treatment, together, reduced the number of amputations by 18.7%.

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Peculiarities Of Treatment Of Purulent-Necrotic Complications In Patients With Diabetic Foot Syndrome

The American Journal of Medical Sciences and Pharmaceutical Research ◽

10.37547/tajmspr/volume03issue06-18 ◽

2021 ◽

Vol 03 (06) ◽

pp. 116-121

Author(s):

Abdullaev R.N. ◽

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Diabetic Foot Syndrome ◽

Septic Complications ◽

Complications Of Diabetes ◽

Surgical Infection ◽

Number Of Patients ◽

Patients With Diabetes

The number of patients with diabetes mellitus in the Andijan region who were registered according to endocrinologists from 2000 to 2015 increased almost fourfold from 26,000 to more than 110,000 in 2016 (14). This also shows that the number of patients with various purulent-necrotic complications of diabetes mellitus also increases proportionally, in addition, there is an increase in patients with severe purulent-septic complications of these processes, with widespread, deep purulent-necrotic fasciitis [3]. Of patients in the department of surgical infection of the ASMI clinic, patients with purulent-necrotic complications of diabetes mellitus account for almost 78%, which indicates a significant increase in the number of these patients. This tendency continues and goes up every year. According to the WHO, by 2030 every 15 people will have diabetes, and by 2050 this figure will be equal to every 6 people.

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Morphological research of the effectiveness of perioperative local use of anesthetics and antiseptics in patients with purulent-necrotic lesions of lower extremities in diabetes mellitus

Reports of Morphology ◽

10.31393/morphology-journal-2021-27(3)-03 ◽

2021 ◽

Vol 27 (3) ◽

pp. 22-28

Author(s):

Yu.M. Babina ◽

D.V. Dmyrtriiev ◽

O.A. Nazarchuk ◽

P.P. Hormash

Keyword(s):

Diabetes Mellitus ◽

Wound Healing ◽

Granulation Tissue ◽

Diabetic Foot ◽

Povidone Iodine ◽

Local Treatment ◽

Lower Extremities ◽

Diabetic Foot Syndrome ◽

Patients With Diabetes ◽

Infiltration Anesthesia

Ulcer-necrotic lesions of the feet are detected in 5-15% of patients with diabetes mellitus (DM). According to the literature today in Ukraine, patients with DM perform high amputation of the lower extremities with diabetic foot syndrome with a frequency of 19.6-42.6%, at the same time, mortality ranges from 8.9% to 25.0%, and the total mortality rate at the DM varies from 6.6% to 13.5%, often associated with the occurrence of postoperative complications. The aim of the work was to study morphological indicators of reparation of soft tissues of the lower extremities in patients with diabetic foot syndrome on the background of local treatment during the perioperative period. We investigated changes in histologic structure and character of reactions of skin tissues, muscles and fascia during the period of visceral disease in patients with diabetes mellitus after different types of local treatment. Then, samples of skin tissues, muscles and fascia were photographed and analyzed using a light microscope OLIMPUS BX 41. In the first group of the comparison, which used standard methods of anesthesia and local antiseptic povidone-iodine, granulation tissue was characterized by the complete absence of fibrous structures (collagen fibers) and the presence of a small number of newly formed small diameter vessels with blistered endothelium. Vessels of young granulation tissue were dilated, full-blooded, the endothelium was swollen, there was significant perivascular edema. In the second group of patients (where povidone-iodine and infiltration anesthesia with 2% lidocaine solution anesthetic was used locally) there were almost no remains of necrotic tissues in the affected tissues. It should be noted that there was better granulation development with fewer inflammatory-cell elements, more young forms of fibroblasts and a moderate pathological vascular reaction. In the first (control) group, wound healing by 3-7 days is characterized by somewhat slow regeneration. Wound healing was most favorable in patients of the second group, where infiltration anesthesia was used by local anesthetic and antiseptic povidone-iodine.

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THE PREVALENCE OF MODIFIABLE RISK FACTORS IN THE POPULATION AND IN PATIENTS WITH DIABETES MELLITES, INCLUDING DIABETIC FOOT SYNDROME

Tavricheskiy Mediko-Biologicheskiy Vestnik ◽

10.37279/2070-8092-2020-23-2-85-91 ◽

2020 ◽

Vol 23 (2) ◽

pp. 85-91

Author(s):

T. Yu. Kravtsova ◽

M. F. Zarivchatskiy ◽

P. S. Lukin ◽

S. F. Blinov ◽

M. V. Bacheva

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Risk Factors ◽

Diabetic Foot ◽

Age Groups ◽

Social Study ◽

Diabetic Foot Syndrome ◽

Modifiable Risk Factors ◽

Patients With Diabetes ◽

Poor Nutrition

Goal of work - identify modifiable risk factors for chronic non-infectious diseases in patients with type 2 diabetes mellitus and in the formation of diabetic foot syndrome. Material and methods. A comparative medical and social study was conducted - a survey of patients in clinics of the city of Perm, suffering and not suffering from diabetes. The study involved 230 people who were assigned according to the presence/absence of diabetes mellitus. The first group included 178 patients with an average age of 45.8 (30.0; 59.0). The second group included 27 patients with diabetes mellitus, with an average age of 61.7 years (50.0; 62.0). The third group included 25 patients with diabetic foot syndrome, whose average age was 64.72 years (61.0; 69.0). Women predominated in all groups. Original and generally accepted questionnaires were used to study the presence of common risk factors for chronic diseases among respondents. Results. The analysis of the studied materials showed a clear qualitative and quantitative pattern of accumulation of risk factors in the age exponent. Most risk factors tend to grow up to 54-65 years. Risk factors such as smoking, alcohol abuse, poor nutrition and overweight, depression and hypertension predominate (р<0,05) in older age groups of respondents. In patients with diabetes mellitus, low physical activity, poor nutrition, and obesity predominate (р<0,05). In patients with diabetic foot syndrome, the same risk factors were identified as in patients without this pathology. At the same time, in respondents with diabetic foot syndrome, physical activity was minimal, and body mass index values were much higher (р<0,05); in addition, patients with diabetic foot syndrome are more likely (р<0,05) to be depressed and perceive their health as «very poor.»

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Analysis of Clinical Profiles, Deformities, and Plantar Pressure Patterns in Diabetic Foot Syndrome

Applied Sciences ◽

10.3390/app112311464 ◽

2021 ◽

Vol 11 (23) ◽

pp. 11464

Author(s):

Claudia Giacomozzi ◽

Giada Lullini ◽

Alberto Leardini ◽

Paolo Caravaggi ◽

Maurizio Ortolani ◽

...

Keyword(s):

Diabetic Foot ◽

Plantar Pressure ◽

Weight Bearing ◽

Descriptive Analysis ◽

Biomechanical Analysis ◽

Diabetic Foot Syndrome ◽

Foot Bones ◽

Patients With Diabetes ◽

Ct Analysis

Diabetic foot syndrome refers to heterogeneous clinical and biomechanical profiles, which render predictive models unsatisfactory. A valuable contribution may derive from identification and descriptive analysis of well-defined subgroups of patients. Clinics, biology, function, gait analysis, and plantar pressure variables were assessed in 78 patients with diabetes. In 15 of them, the 3D architecture of the foot bones was characterized by using weight-bearing CT. Patients were grouped by diabetes type (T1, T2), presence (DN) or absence (DNN) of neuropathy, and obesity. Glycated hemoglobin (HbA1c) and plantar lesions were monitored during a 48-month follow-up. Statistical analysis showed significant differences between the groups for at least one clinical (combined neuropathy score, disease duration, HbA1c), biological (age, BMI), functional (joint mobility, foot alignment), or biomechanical (regional peak pressure, pressure-time integral, cadence, velocity) variable. Twelve patients ulcerated during follow-up (22 lesions in total), distributed in all groups but not in the DNN T2 non-obese group. These showed biomechanical alterations, not always occurring at the site of lesion, and HbA1c and neuropathy scores higher than the expected range. Three of them, who also had weight-bearing CT analysis, showed >40% of architecture parameters outside the 95%CI. Appropriate grouping and profiling of patients based on multi-instrumental clinical and biomechanical analysis may help improve prediction modelling and management of diabetic foot syndrome.

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Integrated surgical management of neuroischemic diabetic foot syndrome, abdominal aortic aneurysm and renal artery lesionsin patients with diabetes mellitus type 2

Diabetes Mellitus ◽

10.14341/2072-0351-5826 ◽

2011 ◽

Vol 14 (4) ◽

pp. 100-106

Author(s):

Sergey Anatol'evich Terekhin ◽

Victor Afanas'evich Kalashnikov ◽

Valeriy Afanas'evich Mitish ◽

Lyudmila Petrovna Doronina ◽

Alla Yur'evna Tokmakova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Abdominal Aortic Aneurysm ◽

Surgical Management ◽

Diabetic Foot ◽

Diabetes Mellitus Type 2 ◽

Diabetic Foot Syndrome ◽

Abdominal Aortic ◽

Patients With Diabetes

The article presents a clinical example of integrated surgical management in patient with multifocal atherosclerosis, chronic kidney disease andneuro-ischemic form of diabetic foot syndrome

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The process of repair of trophic ulcers in patients with diabetes

Problems of Endocrinology ◽

10.14341/probl11391 ◽

2004 ◽

Vol 50 (2) ◽

pp. 34-38

Author(s):

N. A. Myskina ◽

A. Yu. Tokmakova ◽

M. B. Antsiferov

Keyword(s):

Diabetes Mellitus ◽

Blood Flow ◽

Diabetic Foot ◽

Neurological Disorders ◽

Sharp Increase ◽

Lower Extremities ◽

Late Complications ◽

Diabetic Foot Syndrome ◽

Industrialized Countries ◽

Patients With Diabetes

In the last 30 years, there has been a sharp increase in the incidence of diabetes mellitus (DM), especially in industrialized countries, and its prevalence tends to further increase [3]. The main cause of disability and death of patients are late complications of this disease. Among them, it is especially important to identify developing diabetic foot syndrome (DFS), which is defined as infection, ulcer and / or destruction of deep tissues, associated with neurological disorders and decreased main blood flow in the arteries of the lower extremities of varying degrees severity (International Diabetic Foot Agreement, Netherlands, 1999)

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Severe Vitamin D3 Deficiency in the Majority of Patients with Diabetic Foot Ulcers

Hormone and Metabolic Research ◽

10.1055/a-0648-8178 ◽

2018 ◽

Vol 50 (08) ◽

pp. 615-619 ◽

Cited By ~ 9

Author(s):

Joachim Feldkamp ◽

Karsten Jungheim ◽

Matthias Schott ◽

Beatrix Jacobs ◽

Michael Roden

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Cell Function ◽

Glycosylated Hemoglobin ◽

Diabetic Foot Syndrome ◽

Foot Ulcers ◽

Control Group ◽

Diabetic Foot Ulcers ◽

Healthy Humans ◽

Patients With Diabetes

AbstractDiabetic foot ulcers are a severe complication in patients with diabetes mellitus. Vitamin D is associated with impaired β-cell function and insulin resistance, and is necessary for wound healing and bone metabolism. We measured the serum concentrations of 25-hydroxyvitamin D3 in 104 patients (63 inpatients, 41 outpatients) with diabetic foot ulcers and compared them to 99 healthy humans (control) and 103 patients with diabetes mellitus type 2 without diabetic foot ulcers. Calcium, creatinine, and parathyroid hormone were measured in patients with diabetic foot ulcers. The data were analysed together with glycosylated hemoglobin A1c and the severity of diabetic foot lesions according to the Armstrong classification. Levels of 25-hydroxyvitamin D3 were lower (11.8±11.3 ng/ml, p<0.001) in patients with diabetic foot ulcers (mean age 70±12 years) than in the control group (27.2±12.2 ng/ml). No difference was found between in- and outpatients. Fifty-eight (55.8%) of patients with diabetic foot ulcers had a severe 25-hydroxyvitamin D3 deficiency with levels below 10 ng/ml. Only 12% of the patients had 25-hydroxyvitamin D3 levels above 20 ng/ml. Secondary hyperparathyroidism was found in 27.9% of patients and 11.5% of the patients were hypocalcemic. There was a negative correlation (r=–0.241) (p<00.1) between Armstrong classification and 25-hydroxyvitamin D3 status. In conclusion, patients with diabetic foot syndrome are at high risk of 25-hydroxyvitamin D3 deficiency. Thus, any patient with diabetic foot syndrome should undergo 25-hydroxyvitamin D3 measurement and supplementation, if values are found to be decreased.

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