scholarly journals HEMORHEOLOGICAL FAILURE IN THE PATHOLOGY OF CARDIO-VASCULAR COMPLICATIONS IN PATIENTS WITH DIABETIC FOOT SYNDROME

2016 ◽  
Vol 6 ◽  
pp. 57-62
Author(s):  
Еlina Кorobko
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Blood Circulation ◽  
Vascular Complications ◽  
Cardiovascular Complications ◽  
Diabetic Foot Syndrome ◽  
Steady Growth ◽  
Myocardium Infarction ◽  
The World ◽  
Cardio Vascular

The literature that includes the study of cardiovascular complications in patients with diabetic foot syndrome was analyzed. The topicality of this problem is caused by the steady growth of diabetes mellitus morbidity among people. For today there are more than 170 mln people throughout the world with diabetes mellitus, among them 65–80 % have cardiovascular complications (myocardium infarction, acute disorder of brain blood circulation and so on). It is established for today, that pathogenesis of diabetic foot syndrome is multi-factor one and the development of purulent-necrotic stages of DFS is connected with the combination of different factors, especially microcirculation disorder. In this article we’ll consider the mechanisms of diabetic angiopathy development, the state of platelet-vascular hemostasis link in this category of patients.

scholarly journals Economic evaluation of type 2 diabetes mellitus burden and its main cardiovascular complications in the Russian Federation

2016 ◽  
Vol 19 (6) ◽  
pp. 518-527 ◽  
Author(s):  
Ivan I. Dedov ◽  
Anna V. Koncevaya ◽  
Marina V. Shestakova ◽  
Yuriy B. Belousov ◽  
Julia A. Balanova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Russian Federation ◽  
Complex Analysis ◽  
Vascular Complications ◽  
Cardiovascular Complications ◽  
Permanent Disability ◽  
Clinical Investigations ◽  
The Russian Federation ◽  
Cardio Vascular

Background. Diabetes Mellitus Type 2 (DMT2) is a complex medical and social problem in the world and in the Russian Federation also due to prevalence and probability of cardio-vascular complications (CVC).Aim. Economic burden evaluation of DMT2 in the Russian Federation.Methods. Complex analysis of expenditures (direct and non-direct costs) based on epidemiological, pharmacoeconomics and clinical investigations, population and medical statistics data.Results. Calculated expenditures for DMT2 are 569 bln RUR per year, that is correspond to 1% of the Russian GDP, and 34,7% of that are expenditures for main CVC (ischemic heart disease, cardiac infarction, stroke). Main part of expenses are non-medical (losses GDP) due to temporary and permanent disability, untimely mortality – 426,7 bln RUR per year. Expenditures in estimated group of patients with non-diagnosed DMT2 but with already having CVC were at least 107 bln per year (18,8% from total cost). Relationship between cost of DMT2 and degree of it’s control was found in the Russian conditions. Estimated cost for compensated patient (HbA1c6,5%) per year was 88 982 RUR, in the same time cost of non-control patient (HbA1c9,5%) was in 2,8 times higher due to more often main CVC in this group.Conclusion. DMT2 diagnosis improvement as well as effective treatment of early stages of illness can decrease probability of CVC and social economic expenditures. 

scholarly journals The Role of Physical Therapy in the Combined Treatment of Patients with Lower Extremities Diabetic Angiopathies

2021 ◽  
Vol 20 (2) ◽  
pp. 80-87
Author(s):  
Denis V. Frolov
Keyword(s):  
Diabetes Mellitus ◽  
Physical Therapy ◽  
High Mortality ◽  
Physical Training ◽  
Diabetic Foot ◽  
Vascular Complications ◽  
Lower Extremities ◽  
Diabetic Polyneuropathy ◽  
Diabetic Foot Syndrome ◽  
Diabetic Angiopathies

One of the most disabling complications of diabetes mellitus is angiopathy of the lower extremities. Diabetic polyneuropathy and diabetic foot syndrome are closely associated with vascular complications of diabetes mellitus, which significantly aggravate the course of the disease and contribute to high mortality. Diabetic polyneuropathy and diabetic foot syndrome are closely associated with the diabetes mellitus vascular complications that significantly aggravate the course of the disease and contribute to high mortality. Despite the improvement in the results of pharmacotherapy of diabetes mellitus, the problem of treating its vascular complications is far from being solved. Traditionally, therapeutic physical training is used among the methods of non-drug treatment of diabetes mellitus and its complications. As a method of pathogenetic focus on many risk factors for the development of diabetes and its complications, physical therapy exercises contribute to the correction of the syndrome of hypodynamia, obesity, and muscle atrophy. At the same time, there is insufficient data on how exercise therapy affects the quality of life of patients, functional characteristics of walking and objective indicators of blood flow in the lower extremities. This review identifies the main approaches to the application, advantages and disadvantages of individual methods of therapeutic physical training in the correction of functional disorders in patients with lower extremities diabetic angiopathies. We can currently talk about the proven safety of the physical therapy use in patients with diabetic angiopathies. Meanwhile, the scientific data on the high efficiency of this method is still insufficient.

Technique of Atypical Amputation of the Foot in Patients with a Complicated Course of Diabetic Foot Syndrome

2015 ◽  
Vol 22 (3) ◽  
pp. 43-49 ◽  
Author(s):  
Гвазава ◽  
T. Gvazava
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Diabetic Foot ◽  
Blood Circulation ◽  
Lower Extremities ◽  
Duplex Ultrasound ◽  
Diabetic Foot Syndrome ◽  
Control Group ◽  
Ultrasound Study ◽  
Complicated Course

Abstract. Introduction. Diabetes mellitus is one of the most common and socially important diseases in the world. The diabetic foot syndrome is one of the most complex diseases with a view to pathogenesis and one of the most serious complications of diabetes mellitus. This syndrome is characterized by disorders and changes of all structures of lower extremities, causes the ulcerous and necrotic processes. At the current moment, a traditional method in treatment of complications of the diabetic foot syndrome is amputation of lower extremities. Due to the large number of postoperative complications, the most preferable are economic amputations at the level of foot step. In modern conditions in the first stage of complex treatment of patients with purulent-necrotic process in the lower extremities, the recovery of main arterial blood circulation of the lower extremities in the form of open or endovascular angioplasty is effective. The most effective method is revascularization performed according to angiosomes areas of blood flow in footstep. Purpose of this study is to carry out a comparative assessment of the effectiveness of typical and atypical amputations at the level of footstep in patients with the most complicated course of the diabetic foot syndrome. Material. The objects of this study were patients with diabetes mellitus (DM) type 2 with purulent-necrotic complications of diabetic foot, treated at the surgical department department of the National N.I. Pirogov Surgical and Medical Center of the Saint- Petersburg of the SPb Clinical centre for the period 2010-2013. The main group included 68 patients. These patients were performed atypical interventions according to angiosomes blood flow to the tissues of the foot. Operative interventions at the level of footstep were carried out to 47 patients of the control group. Methods. An objective study to assess the local status, laboratory tests (clinical blood test, basic coagulogram, carbohydrate metabolism indexes) and duplex ultrasound study (USDI) of vessels of lower extremities were carried out. Obligatory angiography was performed in all patients. Surgical intervention in the form of dissection, drainage of purulent focus was carried out on an emergency basis prior to angiography only in patients with acute purulent processes in the lower extremities. In all other cases, the individual peculiarities of blood circulation disorder in lower extremities determined the choice of tactics of operative treatment. In 76% and 46% accordingly for each group after angiography, a balloon angioplasty was carried out for reconstruction of the main blood flow. Results and discussion. The average duration of the in-patient treatment in study group was 14,4±2,3. In the control group - 18,2±3,1. Duration of hospitalization differed significantly (p<0.05), but significant group of patients (31 and 18, respectively) were re-hospitalized during the period from 2 to 6 weeks after discharge from the hospital for the purpose of autodermoplasty for closure of surgical wounds. There were no significant differences between the postoperative healing time of wounds and wound surfaces after reconstructive interventions. This indicates the correct choice and method of operation, as well as indications for secondary wound closure. The authors note the difference in number of re-operations for recurrent purulent-necrotic process (2 patients in the study group and 9 patients in the control group). Re-operation was considered in the case of a destructive process to heal the original wound. Relapse necrotic phenomena was the main cause of the increase in terms of the impossibility of independent movement and 6.3±1,2 and 13.1±3.4 days, respectively (p<0.05). The authors explain these results by the fact that the leading role belongs to the qualitative blood circulation of paravulnar tissues in the postoperative wound healing in patients with diabetic foot syndrome. Conclusions. 1. Preoperative angiography is prescribed to patients with purulent-necrotic complications of diabetic foot syndrome. If required, angioplasty before performing surgery on the tissues of the feet. 2. The application of the principle angiosomes blood flow on the basis of the duplex ultrasound study (USDI) of arteries and angiography allows to choose the most rational tactics of surgical treatment. 3. The use of atypical technique of amputations in the foot after preoperative examination can reduce the number of postoperative complications and the duration of inpatient treatment, to improve postoperative mobility and difficulty walking patients.

Mechanisms underlying heart failure in type 2 diabetes mellitus

2019 ◽  
pp. 37-39
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Experimental Studies ◽  
Vascular Complications ◽  
Molecular Alterations ◽  
Increased Risk ◽  
Cardioprotective Effects ◽  
Underlying Mechanisms ◽  
Cardio Vascular

The prevalence of heart failure is markedly increased in individuals with diabetes mellitus. Numerous observational studies suggest that this increased risk for heart failure can be attributed to exacerbated vascular complications and the presence of increased risk factors in diabetic subjects. In addition, experimental studies revealed the presence of a number of distinct molecular alterations in the myocardium that occur independently of vascular disease and hypertension. Many of these molecular alterations are similarly observed in failing hearts of nondiabetic patients and have thus been proposed to contribute to the increased risk for heart failure in diabetes. The interest in understanding the underlying mechanisms of impaired cardio- vascular outcomes in diabetic individuals has much increased since the demonstration of cardioprotective effects of SGLT-2 inhibitors and GLP-1 receptor agonists in recent clinical trials. The current review therefore summarizes the distinct mechanisms that have been proposed to increase the risk for heart failure in diabetes mellitus.

scholarly journals Endothelial Dysfunction in Diabetes Mellitus: Possible Involvement of Endoplasmic Reticulum Stress?

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Basma Basha ◽  
Samson Mathews Samuel ◽  
Chris R. Triggle ◽  
Hong Ding
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Clinical Trials ◽  
Endoplasmic Reticulum ◽  
Endothelial Dysfunction ◽  
Er Stress ◽  
Vascular Complications ◽  
Cardiovascular Complications ◽  
Therapeutic Agents ◽  
Recent Past

The vascular complications of diabetes mellitus impose a huge burden on the management of this disease. The higher incidence of cardiovascular complications and the unfavorable prognosis among diabetic individuals who develop such complications have been correlated to the hyperglycemia-induced oxidative stress and associated endothelial dysfunction. Although antioxidants may be considered as effective therapeutic agents to relieve oxidative stress and protect the endothelium, recent clinical trials involving these agents have shown limited therapeutic efficacy in this regard. In the recent past experimental evidence suggest that endoplasmic reticulum (ER) stress in the endothelial cells might be an important contributor to diabetes-related vascular complications. The current paper contemplates the possibility of the involvement of ER stress in endothelial dysfunction and diabetes-associated vascular complications.

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 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 Diabetic Foot Spa Implementation in Early Neuropathy Diagnosis Based on Blood Glucose Levels, Foot Sensitivity and the Ankle Brachial Index in Patients with Diabetes Mellitus

Jurnal NERS ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 106
Author(s):  
Erika Martining Wardani ◽  
Chilyatiz Zahroh ◽  
Nur Ainiyah
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Vascular Complications ◽  
P Value ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes ◽  
Foot Problems

Introduction: Diabetes Mellitus (DM) is a cause of morbidity mainly due to vascular complications. The prevention of diabetic foot problems can be done through metabolic control and foot exercises. The purpose of this study was to determine the effect of diabetes foot spa measures on blood glucose levels, foot sensitivity and the ankle brachial index.Methods: This research was a pre-experimental design. The population totaled 170 DM patients and the sample was finalized at 30 respondents. The independent variable was diabetic foot spa, while the dependent variables were blood glucose levels, blood sensitivity and the ankle brachial index. The data was analyzed using a t-test and Wilcoxon rank test.Results: Diabetic foot spa in early neuropathy detection testing has a blood glucose level of t=9.523 and a p value=0.000. Diabetic foot spa also significantly affects foot sensitivity with a ρ <α (0.001<0.05) and an ankle brachial index of (ABI) ρ<α (0.008 < 0.05).Conclusion: Diabetic foot spa conducted regularly and independently can reduce the level of complications in Diabetes Mellitus patients. Furthermore, the tingling and pain in the feet can be reduced or even disappear as well as preventing complications such as foot ulcers that can often become amputations.

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