scholarly journals THE PREVALENCE OF GENETIC POLYMORPHISMS FOR REGULATION OF VASCULAR TONE, PLATELET RECEPTORS, VASCULAR WALL REMODELING AND PROTHROMBOTIC FACTORS IN DIABETIC FOOT SYNDROME

2021 ◽  
Vol 29 (5) ◽  
pp. 549-557
Author(s):  
N.I. Troitskaya ◽  
◽  
K.G. Shapovalov ◽  
V.A. Mudrov ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gene Polymorphism ◽  
Diabetic Foot ◽  
Gene Polymorphisms ◽  
Vascular Tone ◽  
Vascular Wall ◽  
Mthfr Gene ◽  
Diabetic Foot Syndrome ◽  
Frequency Of Occurrence ◽  
Allelic Variants

Objective. To analyze the frequency of occurrence of eNOS 786C>T, END1 Lys198Ash, ITGB3 1565T>C (Leu33Pro), F5 1691G>A, F2 20210G>A, MMP9 8202A>G, MTHFRA 1298 C,VEGFA 634C>G gene polymorphisms in diabetic foot syndrome. Methods. The study included patients (n=198) with uncomplicated diabetes mellitus and patients (n=199) with the development of diabetic foot syndrome. Genotyping of the studied gene polymorphisms was performed by the polymerase chain reaction method. Results. In patients with uncomplicated diabetes mellitus and in patients with diabetic foot, no significant differences were found in the frequency of occurrence of polymorphisms 786C>T of the eNOS3 gene, Lys198Ash of the END1 gene, 1691G>A of the F5 gene, 20210G>A of the F2 gene, 8202A>G of the MMP9 gene, 634C> G of the VEGFA gene and their allelic variants. Associative relationship between the polymorphisms of the NOS 786C>T, END1 Lys198Ash, F5 1691G>A, F2 20210G>A, MMP9 8202A>G, VEGFA 634C>G genes and the development of diabetic foot syndrome was not found. With the development of a diabetic foot, a heterozygous variant of the 1565TС polymorphism of the ITGB3 gene was more common than in uncomplicated diabetes mellitus (37.7% and 28.3%, respectively (χ²=6.243, p=0.045)). The risk of developing a diabetic foot with the carriage of this polymorphism is 1.5 times higher than with other variants of gene polymorphism ((OR=1.534 (95% Cl 1.006 - 2.338), p<0.05). Polymorphism 1298 AS of the MTHFR gene was more often detected in the group of patients with uncomplicated diabetes mellitus than in the group with the development of diabetic foot (45.4% and 29.1%), (χ²=11.55, p=0.004). Conclusion. The development of diabetic foot syndrome is associated with the carriage of the heterozygous 1565TС polymorphism of the ITGB3 gene, in which the likelihood of developing this complication increases 1.5 fold. In diabetes mellitus without complications, a more frequent carriage of the heterozygous polymorphism 1298 AC of the MTHFR gene was revealed, which may have a protective effect against the development of diabetic foot syndrome. What this paper adds The frequency of occurrence of genetic polymorphisms for regulating vascular tone, platelet receptors, vascular wall remodeling and prothrombotic factors and their allelic variants in diabetic foot syndrome was studied. It was found that the frequency of heterozygous 1565TС polymorphism of the ITGB3 gene in the development of diabetic foot is 1.3 fold higher than in the uncomplicated course of the disease. It was revealed that the fregnency of this variant of the ITGB3 gene polymorphism is associated with the risk of developing this complication of diabetes mellitus. In the presence of the heterozygous 1565TС polymorphism of the ITGB3 gene, the risk of developing diabetic foot syndrome increases by 1.5 fold than with the carriage of other variants of the T1565С polymorphism of the ITGB3 gene. It was found that in the uncomplicated course of the disease, the heterozygous genotype 1298 AC of the MTHFR gene occurs 1.6 fold more often than in the development of diabetic foot syndrome.

scholarly journals Study of the influence of vacuum therapy on the wound process in patients with diabetic foot syndrome

2019 ◽  
Vol 74 (4) ◽  
pp. 283-288
Author(s):  
Petr A. Gerasimchuk ◽  
Alexander V. Shidlovskyi ◽  
Dmitriy B. Fira ◽  
Andrey V. Pavlyshyn
Keyword(s):  
Diabetes Mellitus ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Chronic Wound ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Vacuum Therapy ◽  
Social Significance ◽  
Number Of Patients ◽  
Bed Days

Background: According to the International Diabetes Federation (IDF), the number of patients on diabetes mellitus is now more than 415 million people on Earth, until 2030 it will increase to 439 million, and by 2035 ― will reach 592 million. Throughout life, 4.625% of patients with diabetes mellitus develops a diabetic foot syndrome with the formation of wounds, whose treatment, can not yet be considered satisfactory, since in 1525% of patients are the direct cause of high amputations of the lower limbs. This requires finding new effective methods for treating wound defects in patients with diabetic foot syndrome, one of which can be vacuum wound therapy. Aims: To study the effectiveness of vacuum therapy in the treatment of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenetic form of the lesion. Materials and methods: The effect of vacuum therapy on the course of acute and chronic wound process in 231 patients with neuropathic and ischemic form of diabetic foot syndrome was studied during 20142017. Evaluation of the dynamics of the wound process was carried out on the basis of clinical, planimetric, microbiological, morphological methods, as well as microcirculation indices in the area round the wound. Results: Vacuum therapy of acute and chronic wounds in patients with different pathogenetic forms of diabetic foot syndrome, allows to stabilize the course of wound process, stimulate regenerative processes in the wound, improve local microcirculation (p0.05). This, in turn, allows a shorter time to prepare a wound for closure by one of the methods of plastic surgery or create favorable conditions for its independent epithelization. In patients with ischemic lesions (chronic arterial insufficiency of the third degree), the carrying out of vacuum therapy by standard method leads to an intensification of the pain syndrome. This causes the need to apply an initial negative pressure in the system in the range of 7080 mm Hg, which makes it possible to stop pain during the day. At 23 days of the postoperative period, negative pressure is established at standard values. Conclusions: Vacuum therapy of wounds in patients with diabetic foot syndrome is an effective method of treatment that allows the doctor to reduces the duration of treatment of patients in hospital with a neuropathic form of diabetic foot syndrome on average (4.31.7) bed-days, and patients with ischemic form ― on average (4.11.9) bed-days, which has both medical and social significance.

scholarly journals Association of Vitamin D Receptor Gene Polymorphism with Type 2 Diabetes in the Northern Region of Saudi Arabian Population

2021 ◽  
pp. 359-366
Author(s):  
Ahmed Alharbi ◽  
Md Jahoor Alam ◽  
Mohd Saeed
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Saudi Arabia ◽  
Gene Polymorphism ◽  
Gene Polymorphisms ◽  
Vdr Gene ◽  
Vdr Gene Polymorphisms

Background: Vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms are associated with type 2 diabetes mellitus (T2DM), However, its association with type 2 diabetes mellitus) is controversial and has not been established in different ethnic populations. Therefore, we aimed to evaluate the possible association between VDR gene polymorphisms (Fok1, Bsm1, and Taq1and Apa1) and T2DM patients in Saudi Arabia. Methods: 100 patients with T2DM and 100 healthy age-matched control subjects were enrolled. Fasting blood glucose, lipids profile and HbA1c were measured by autoanalyzer. The circulatory level of 25 hydroxyvitamin D [25(OH)D] was measured by immunochemiluminance. VDR gene polymorphisms detection has been done by polymerase chain reaction through restriction fragment length polymorphism (PCR-RFLP) method. Results: Our study has shown lower levels of 25(OH) D in patients with T2DM (in comparison with control subjects (44.65 ± 7.19), p < 0.00. There were statistically significant differences between patients with type 2 diabetes and controls regarding the distribution of FokI and Taq1 genotypes and alleles (p<0.004 and p<0.04) and nonsignificant differences regarding Bsm1genotpes and allele. Conclusions: Vitamin D deficiency is prevalent in T2DM patients in Saudi Arabia. An association was found between VDR FokI and Taq1 gene polymorphism and susceptibility to T2DM in Saudi Arabian patients.

scholarly journals DIABETIC FOOT SYNDROME

2021 ◽  
pp. 139-143
Author(s):  
H.A. Bliznets ◽  
◽  
I.A. HadjiIsmail ◽  
A.C. Shuleiko ◽  
V.M. Shyshko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Premature Mortality ◽  
Cost Effective ◽  
Diabetic Foot Syndrome ◽  
Vascular Lesions ◽  
Modern World ◽  
Common Disease ◽  
Cost Effective Treatment ◽  
Working Age

In the modern world, diabetes mellitus is a common disease with multiple consequences, the main complications are vascular lesions (macroangiopathy) and nerves, which are the cause of many complications, such as chronic renal failure and blindness and amputations in patients of working age, which leads to early disability and premature mortality. In the treatment of diabetes mellitus, most of the costs are for the treatment of complications, and the most cost-effective treatment is still treatment for ulcers of the feet. The article defines the essence and classification of diabetic foot syndrome, highlights the stages of diagnosis, as well as the main approaches to its treatment, describes the basics of prevention.

scholarly journals Orthoses in diabetic foot treatment and prevention

2013 ◽  
Vol 94 (4) ◽  
pp. 536-541
Author(s):  
I V Klyushkin ◽  
K A Koreyba
Keyword(s):  
Diabetes Mellitus ◽  
Elastic Material ◽  
Diabetic Foot ◽  
Silver Ions ◽  
Cost Effective ◽  
Diabetic Foot Syndrome ◽  
Treatment And Prevention ◽  
Positive Treatment ◽  
Orthopedic Shoes

Aim. To define the role of orthoses in the treatment and rehabilitation of patients with diabetic foot syndrome. Methods. The review of the literature addressing the use of special orthopedic shoes in the treatment and rehabilitation of patients with complicated diabetes mellitus was performed. Results. The common requirements for orthopedic shoes for patients with complicated diabetes mellitus are the following: (1) rigid sole with an artificial curvature; (2) boot-tree elevated by 8 mm due to arch supporter, adequate volume, wide sole, removable insole; (3) insole without functional memory; (4) thermally variable elastic material, advisably with silver ions, for the lining; (5) minimal number of sutures at the lining; (6) no elastic material at the front of the shoe and at the lining at the toes; (7) increased volume and enough space for the toes; (8) front slant of 15°; (9) potential ability to adjust the inner volume of the shoe; (10) hard counter - stabilizing hard back with additional softening at the lining side; (11) heel with a front slant or a solid sole without a heel; (12) smooth non-traumatic surface suitable for scrubbing including cleansing with antiseptics. The indications for orthopedic relief in patients with diabetic foot syndrome are explained. Economic superiority of organ-preserving approaches in such patients is shown. There is an opposition for conservative methods of treatment of patients with diabetic foot syndrome, nevertheless, an amputation can not be estimated as a positive treatment outcome in such patients. Almost 70-90% of ulcers in this group of patients are healed without amputation. Limb-saving treatment and the use of specially selected shoes are cheaper and more cost-effective compared to the limb loss. Conclusion. The use of orthopedic shoes in patients with diabetic foot syndrome is used both for treatment and rehabilitation. This technique can reduce the risk of ulceration and prevent organ-sparing surgeries.

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

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.

scholarly journals 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

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.

scholarly journals Surfactant Protein D Gene Polymorphism was Associated with the Susceptibility of Gestational Diabetes Mellitus: A Case Control Study

2021 ◽  
Author(s):  
Jingwei Xu ◽  
Yi Chen ◽  
Liangfang Tang ◽  
Xinyuan Teng ◽  
Lin Feng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gene Polymorphism ◽  
Gestational Diabetes Mellitus ◽  
Gene Polymorphisms ◽  
Surfactant Protein ◽  
Surfactant Protein D ◽  
Coding Region ◽  
Increased Risk ◽  
Relationship Of

Abstract BackgroundSurfactant protein D (SP-D) is a critical component of the innate immune system intrinsically linked to energetic metabolism. However, the relationship of SP-D gene polymorphisms and gestational diabetes mellitus (GDM) remains unclear yet. In this study, we analyzed SP-D gene polymorphisms in GDM patients and non-diabatic controls, and then determined the association of SP-D gene polymorphisms with GDM.MethodsWe examined a common genetic polymorphism located in the SP-D coding region (rs721917, Met31Thr) with GDM patients (n = 147) and healthy pregnant controls (n = 97) by using a PCR-RFLP technique. The level of SP-D protein in serum of GDM patients and non-diabetic controls was determined by ELISA method. The gene and allele frequencies od SP-D and their association with GDM as well as SP-D protein level were analyzed using SPSS software.ResultsWe found that there exists a significant association of the SP-D polymorphism (rs721917) with GDM. SP-D (T/T) genotype had 11.6% and 21.6% in GDM and matched healthy controls, respectively (P<0.05); indicating women with (T/T) genotype have lower prevalence of GDM (OR = 0.473). Women with T/C genotypes showed an increased risk of GDM (OR = 2.440). We did not observe corrections between glucose homeostasis markers and SP-D genotypes in the women patients with GDM. Furthermore, serum SP-D level was higher in the GDM compared to matched healthy controls.ConclusionsThis study has found the first evidence that SP-D gene polymorphism (rs721917) was associated with GDM, which may provide the basis for further study how SP-D plays a regulatory role in GDM.

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

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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