Pharmacological treatments for diabetic foot disease: current state and future perspectives

2020 ◽  
Vol 26 ◽  
Author(s):  
Prashanth R J Vas ◽  
Erika Vainieri ◽  
Natasha Patel
Keyword(s):  
Diabetic Foot ◽  
Standard Of Care ◽  
Routine Care ◽  
Pharmacological Treatments ◽  
Foot Care ◽  
Charcot Neuroarthropathy ◽  
Novel Technologies ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
The Individual

: The care of the individual with diabetic foot disease (DFD) represents a significant challenge. In addition to the primary foot pathology, individuals with DFD are frequently compromised by multiple co-existent medical complications. Successful management of DFD therefore requires simultaneous addressal of these issues alongside high-quality foot care. We explore the pharmacological treatments in DFD with an emphasis on the emerging putative technologies centred on addressing the pathobiology of wound healing but also discuss developments in infection control, Charcot neuroarthropathy, cardiovascular and diabetes care. Many of these will have a significant impact on future treatment paradigms and how we amalgamate these novel technologies may help shape the standard of care in DFD hereafter. However, there is a need for better quality of evidence and cost-effectiveness data prior to widespread adoption into routine care is considered.

scholarly journals Assessment of Prevalence, Associations ,Knowledge, and Practices about Diabetic Foot Disease in a Tertiary Care Hospital in Colombo, Sri Lanka

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
V. T. S. Kaluarachchi ◽  
D. U. S. Bulugahapitiya ◽  
M. H. Arambewela ◽  
M. D. Jayasooriya ◽  
C. H. De Silva ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Sri Lanka ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Foot Care ◽  
Diabetic Foot Disease ◽  
Care Practices ◽  
Foot Disease

Background. One in five adults in Sri Lanka has either diabetes or prediabetes, and one-third of those with diabetes are undiagnosed. Diabetic foot is a debilitating condition affecting up to 50% of patients with both type 1 and type 2 diabetes. The risk of nontraumatic lower limb amputations is 15 times higher in diabetic patients when compared with nondiabetics. Patient education about correct foot care practices is the cornerstone of prevention of diabetic foot disease. Objective. To assess the prevalence of diabetic foot disease, knowledge, and practices about diabetic foot care among diabetic patients. Methods. 334 patients attending the diabetic clinic in Colombo South Teaching Hospital were recruited according to the inclusion and exclusion criteria. Data were collected using 3 questionnaires, and they were filled using the foot examination findings, patients’ medical records, and direct interviewing of the patients. Results. The mean age of the patients included in the study was 58.23 ± 10.65 years while the median duration of diabetes was 10.54 ± 7.32 years. 34.1% patients had peripheral neuropathy, and 29.5% had peripheral vascular disease. Diabetic foot disease according to the WHO definition was present only in 23 (6.9%) patients. There was a significant association between peripheral neuropathy and current or past foot ulcer which took more than 2 weeks to heal ( p < 0.05 ). Knowledge about foot care was less among the studied population, and it was associated with poor foot care practices. Presence of diabetic foot and current or past foot ulcer which took more than 2 weeks to heal were significantly associated with the foot care knowledge and practices ( p < 0.05 ) Conclusion. Improvement of patients’ knowledge about foot care and their practices have a significant impact on the reduction of diabetic foot disease.

Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death

2017 ◽  
Vol 11 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Dane K. Wukich ◽  
Katherine M. Raspovic ◽  
Natalie C. Suder
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Lower Extremity Amputation ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Charcot Neuroarthropathy ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Extremity Amputation

Background. The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. Methods. We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations. The control group (N = 254) was comprised of patients with diabetes who presented with common non–diabetes-related foot pathology. Results. A total of 461 patients were enrolled in this study and included 254 patients without diabetic foot complications and 207 patients with diabetic foot problems. When comparing patients with and without diabetic disease, no significant differences were observed with regard to their fear of blindness, DFI, or ESRD requiring dialysis. Patients with diabetic foot disease (61 of 207, 31.9%) were 136% more likely (odds ratio [OR] = 2.36; 95% CI = 1.51-3.70; P = .002] to rank major LEA as their greatest fear when compared with diabetic patients without foot disease (42 of 254, 16.5%) and were 49% less likely (OR = 0.51; 95% CI = 0.34-0.79; P = .002) to rank death as their greatest fear compared with patients without diabetic foot disease. Conclusion. Patients with diabetic foot pathology fear major LEA more than death, foot infection, or ESRD. Variables that were associated with ranking LEA as the greatest fear were the presence of a diabetic-related foot complication, duration of DM ≥10 years, insulin use, and the presence of peripheral neuropathy. Levels of Evidence: Level II: Prospective, Case controlled study

scholarly journals Evaluation of Charcot Neuroarthropathy in Diabetic Foot Disease Patients at Tertiary Hospital

2016 ◽  
Vol 07 (06) ◽  
pp. 250-257 ◽  
Author(s):  
Ahmed M. A. Kensarah ◽  
Nisar Haider Zaidi ◽  
Abdulhaleem Noorwali ◽  
Hager Aref ◽  
Ahmed Mohammed Makki ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Tertiary Hospital ◽  
Charcot Neuroarthropathy ◽  
Diabetic Foot Disease ◽  
Foot Disease

scholarly journals Awareness of diabetic foot disease among patients with diabetes mellitus in Al-Ahsa Saudi Arabia

2021 ◽  
Vol 8 (12) ◽  
pp. 3506
Author(s):  
Abdulaziz S. Aldhafar ◽  
Mohamed Abdullah ◽  
Abdulaziz K. Althafar
Keyword(s):  
Diabetes Mellitus ◽  
Saudi Arabia ◽  
Diabetic Foot ◽  
Diabetic Patients ◽  
Foot Care ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Knowledge Attitude And Practice

Background: The prevalence of diabetes mellitus (DM) in Saudi Arabia is 18.3% in 2020. One of the most common complications that affects diabetic patients is diabetic foot disease (DFD). Patient education is the most effective way to reduce the complications of DFD.Methods: A cross-sectional study was conducted in the period from January to May 2021. A pretested standardized questionnaire was used to collect information upon knowledge, attitude and practice toward diabetic foot care. Data entry was performed using SPSS.Results: The responses of 480 of which 294 male and 186 female, 41.6% have high school degree, 19.3% have bachelor’s degree and 2.2% have master or Ph. D. degree. The mean age of the respondents was 47 years. The 58% of the participant agreed that they might develop reduce flow to their feet. half of the participant were not aware that smoking can reduce blood flow in their feet. There were only 2.3% of the respondents attended a class on how to care of the foot. Participants who received information about foot care from a nurse and physician were 23% and 9.2% respectively. The 97.5% of the participant would like to know how to care for their foot. 75.8% of participants walk barefoot and 42.2% use a comfortable coated shoe.  Conclusions: Participants have inadequate knowledge, attitude and practice about DFD. providing a structured educational program about diabetic foot care has significant impact on diabetic patient to improve their knowledge and practices and to motivate them to have a positive attitude toward diabetic foot care.

scholarly journals Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Thea T. Goie ◽  
Mergan Naidoo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Foot ◽  
Regional Hospital ◽  
Foot Care ◽  
Diabetic Foot Disease ◽  
Foot Disease

Background: Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM).Methods: An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa.Results: Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p < 0.05).Conclusion: The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

scholarly journals Effectiveness of a Self-Foot-Care Educational Program for Prevention of Diabetic Foot Disease

Health ◽  
2019 ◽  
Vol 11 (01) ◽  
pp. 9-19
Author(s):  
Kayo Yokota ◽  
Yuko Hayashi ◽  
Junichi Kurata ◽  
Atsuyo Fujita
Keyword(s):  
Diabetic Foot ◽  
Educational Program ◽  
Foot Care ◽  
Diabetic Foot Disease ◽  
Foot Disease

The Diabetic Foot Attack: “’Tis Too Late to Retreat!”

2018 ◽  
Vol 17 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Prashanth R. J. Vas ◽  
Michael Edmonds ◽  
Venu Kavarthapu ◽  
Hisham Rashid ◽  
Raju Ahluwalia ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Best Practice ◽  
Wound Care ◽  
Severe Infection ◽  
Stroke Care ◽  
Charcot Neuroarthropathy ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Systemic Symptoms ◽  
The Moment

The “diabetic foot attack” is one of the most devastating presentations of diabetic foot disease, typically presenting as an acutely inflamed foot with rapidly progressive skin and tissue necrosis, at times associated with significant systemic symptoms. Without intervention, it may escalate over hours to limb-threatening proportions and poses a high amputation risk. There are only best practice approaches but no international protocols to guide management. Immediate recognition of a typical infected diabetic foot attack, predominated by severe infection, with prompt surgical intervention to debride all infected tissue alongside broad-spectrum antibiotic therapy is vital to ensure both limb and patient survival. Postoperative access to multidisciplinary and advanced wound care therapies is also necessary. More subtle forms exist: these include the ischemic diabetic foot attack and, possibly, in a contemporary categorization, acute Charcot neuroarthropathy. To emphasize the importance of timely action especially in the infected and ischemic diabetic foot attack, we revisit the concept of “time is tissue” and draw parallels with advances in acute myocardial infarction and stroke care. At the moment, international protocols to guide management of severe diabetic foot presentations do not specifically use the term. However, we believe that it may help increase awareness of the urgent actions required in some situations.

scholarly journals Awareness of Diabetic Foot Disease and Practice of Foot Care among Patients with Diabetes Mellitus in Tertiary Healthcare Centers

2020 ◽  
Vol 6 (2) ◽  
pp. 36-39
Author(s):  
Shashikala Manjunatha ◽  
Kaladi Anjinappa Suhasini ◽  
Basavaraju Santosh ◽  
Channaveeradevaru Chandrakala
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Care ◽  
Patients With Diabetes ◽  
Tertiary Healthcare ◽  
Diabetic Foot Disease ◽  
Foot Disease
Sign in / Sign up

Export Citation Format

Share Document