The Healing Process in Diabetic Patients with Peripheral Artery Disease: Cell Therapy for Reducing Foot Wound Cicatrization Time

2021 ◽  
Author(s):  
A. Dosda ◽  
B. Lehalle ◽  
P. Jan ◽  
R. Caillet ◽  
F. Zhang
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Artery Disease ◽  
Healing Process ◽  
Multidisciplinary Care ◽  
Diabetic Patients ◽  
Peripheral Artery ◽  
Optimal Care ◽  
High Prevalence ◽  
Artery Disease ◽  
Disease Cell

Diabetes mellitus (DM) is an endemic disease with a high prevalence and leads to many complications, including peripheral artery disease (PAD). Furthermore, PAD is, like hyperglycemia, an obstacle to the cicatrization process, and increases the risk of foot infections. Therefore, foot wounds in diabetic patients with PAD need more time for cicatrization. We conducted a retrospective analysis of the length and conditions of cicatrization in diabetic patients with PAD with foot wounds, who were dealt with in multidisciplinary care by the authors in 2017 and 2018. Despite optimal care, our study points out that for some patients with PAD, the healing process is long and is a real medical challenge.

scholarly journals High prevalence of exercise-induced ischemia in the asymptomatic limb of patients with apparently strictly unilateral symptoms and unilateral peripheral artery disease

2019 ◽  
Vol 13 ◽  
pp. 175394471881906 ◽  
Author(s):  
Samir Henni ◽  
Pascal Bauer ◽  
Tanguy Le Meliner ◽  
Jeanne Hersant ◽  
Xavier Papon ◽  
...  
Keyword(s):  
Pressure Drop ◽  
Peripheral Artery Disease ◽  
Systolic Pressure ◽  
Diabetic Patients ◽  
Peripheral Artery ◽  
Pressure Index ◽  
High Prevalence ◽  
Artery Disease ◽  
Exercise Induced ◽  
Brachial Systolic Pressure

Background: The prevalence of exercise-induced ischemia in the asymptomatic limb of patients with unilateral claudication based on history and treadmill evaluation, and with unilateral ipsilateral peripheral artery disease (i.e ankle-to-brachial systolic pressure index <0.90) is unknown. Methods: We detected exercise-induced ischemia in the asymptomatic limb of patients with apparently unilateral claudication. Among 6059 exercise-oximetry tests performed in 3407 nondiabetic and 961 diabetic patients. We estimated the intensity of ischemia in the both limb (buttocks and calves) using the lowest minimum value of the decrease from rest of oxygen pressure (DROP; limb changes minus chest changes from rest), with significant ischemia defined as DROP lower than −15 mmHg. Results: We found 152 tests performed in 142 nondiabetic patients and 40 tests performed in 38 diabetic patients. The asymptomatic limb showed significant ischemia in 46.7% and 37.5% of the tests. Strictly unilateral exercise-induced claudication with apparently unilateral peripheral artery disease was rare (<4% of all tests). However, among these highly selected tests, significant ischemia was found in the asymptomatic limb in more than one-third of cases. Conclusion: The asymptomatic limb of patients with peripheral artery disease should not be considered a normal limb.

scholarly journals PENGEMBANGAN PROTOKOL PENGKAJIAN SIRKULASI KAKI PADA PASIEN DIABETES MELITUS

2019 ◽  
Vol 3 (2) ◽  
pp. 145
Author(s):  
Bayu Azhar ◽  
Dewi Elizadiani Suza ◽  
Yesi Ariani
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Artery Disease ◽  
Nurse Practitioners ◽  
Care Quality ◽  
Diabetic Patients ◽  
Peripheral Artery ◽  
Purposive Sampling ◽  
Artery Disease ◽  
Diabetes Melitus ◽  
Nurses Knowledge

Kaki diabetik merupakan komplikasi akibat gangguan sirkulasi dan neuropati. Pasien diabetes melitus memiliki resiko mengalami gangguan penyakit arteri perifer merupakan komplikasi makrovaskuler dan mikrovaskuler mengakibatkan terganggunya sirkulasi pembuluh darah. Diagnostik awal dapat melakukan pemeriksaan pengkajian sirkulasi kaki pasien diabetes. Tujuan penelitian yaitu pengembangan protokol pengkajian sirkulasi kaki pasien diabetes mellitus. Desain penelitian menggunakan action reseach yang dilakukan satu siklus di Rumah Sakit Umum Mitra Medika Tanjung Mulia Medan, dengan teknik purposive sampling. Instrumen penelitian in-depth interview, focus grup discussion, kuesioner pengetahuan perawat tentang pengkajian sirkulasi kaki pasien diabetes melitus. Partisipan terdiri dari 45 perawat ruangan. Hasil penelitian menghasilkan 4 tema: 1) Strategi penerapan protokol pengkajian sirkulasi kaki pasien diabetes melitus, 2) Manfaat dalam penerapan protokol pengkajian sirkulasi kaki pasien diabetes melitus, 3) Hambatan dalam penerapan protokol pengkajian sirkulasi kaki pasien diabetes melitus, dan 4) Teknik dan penerapan protokol pengkajian sirkulasi kaki pasien diabetes melitus. Hasil analisis kuantitatif tingkat pengetahuan perawat sebelum kegiatan penelitian 86,66%, dan meningkat menjadi 100% setelah kegiatan penelitian. Direkomendasikan pelaksanaan pengkajian sirkulasi kaki pasien diabetes melitus sesuai standar prosedur sehingga dapat mengidentifikasi sirkulasi kaki pasien diabetes melitus, memperbaiki kualitas pelayanan keperawatan, meningkatkan kompetensi perawat. Kata kunci: Protokol, pengkajian sirkulasi kaki, diabetes melitus Abstract Development of protocol assessment of feet circulation in diabetes melitus patients. Diabetic foot is complication caused by circulation disorder and neuropathy in patients who have the risk for peripheral artery disease which is the complication of macro-vascular and micro-vascular which can eventually cause the incidence of circulation disorder in blood vessels. Initial diagnostic can be done to prevent peripheral artery disease by using circulation studying examination on the feet of diabetic patients. Therefore, it’s necessary to develop studying protocol of foot circulation in diabetes mellitus patients at Mitra Medika Hospital, Medan. The research instrument was interviews, in-depth interviews, guidance for focus group discussion, self-report of nurses’ knowledge of studying on foot circulation diabetic patients. Participants from 45 nurse practitioners, taken by using purposive sampling technique. The data were analyzed qualitatively and quantitatively. Qualitative data were analyzed by using content analysis while quantitative data were analyzed by using descriptive statistic test. The result of the research showed that 4 themes: 1) strategy of implementing studying protocol of foot circulation diabetes mellitus patients, 2) the benefit of studying protocol of foot circulation diabetes mellitus patients, 3) obstacles in studying protocol of foot circulation diabetes mellitus patients, and 4) technique and implementation of studying protocol of foot circulation diabetes mellitus patients. The result of quantitative analysis showed that nurses’ knowledge in pre-research of was 86.66% and increased to 100% in post research activity. The output of this research result was the standard of studying foot circulation diabetes mellitus patients. It’s recommended the implementation of studying foot circulation accordance with the standard of procedure so that it can identify diabetes mellitus patients’ foot circulation, nursing care quality should be improved, and nurses’ competence should be increased. Keywords: protocol, assessment of foot circulation, diabetes mellitus

scholarly journals Deteksi Dini Penyakit Arteri Perifer pada Pasien Diabetes Melitus di Kota Mataram

2020 ◽  
Vol 2 (3) ◽  
pp. 256-262
Author(s):  
Yanna Indrayana ◽  
Herpan Syafii Harahap ◽  
Ilsa Hunaifi
Keyword(s):  
Diabetes Mellitus ◽  
Early Detection ◽  
Peripheral Artery Disease ◽  
Blood Glucose Control ◽  
Public Health Problem ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Peripheral Artery ◽  
Artery Disease

Diabetes mellitus is currently becoming a major public health problem in the world. The prevalence of diabetes mellitus globally in 2019 is estimated at 9.3% and will increase to 10.9% in 2040. Peripheral artery disease is one of the important complications of diabetes mellitus. Patients with diabetes mellitus accompanied by peripheral artery disease have high morbidity and. Therefore, early detection of peripheral artery disease in diabetic patients is important. This event is carried out with the aim of early detection of peripheral artery disease in diabetes mellitus sufferers in Mataram. A total of 183 diabetes mellitus patients at the Siti Hajar Hospital, Mataram, were participated in this event, with an average age of 57 years and 67.8% of them were women. Most of the patients (75.4%) had poor blood glucose control. Of these, 26.8% of patients had peripheral artery disease. Patients and/or caregivers showed high enthusiasm during the education regarding the detection results of the peripheral artery disease. This event was very useful in increasing the knowledge of diabetic patients, especially in terms of blood sugar control, prevention, and management of peripheral artery disease.

scholarly journals The prognosis of diabetic patients with high ankle-brachial index depends on the coexistence of occlusive peripheral artery disease

2011 ◽  
Vol 53 (4) ◽  
pp. 984-991 ◽  
Author(s):  
Victor Aboyans ◽  
Philippe Lacroix ◽  
Minh-Hoang Tran ◽  
Claire Salamagne ◽  
Sophie Galinat ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Diabetic Patients ◽  
Peripheral Artery ◽  
Artery Disease

scholarly journals Impact of diabetes type on treatment and outcome of patients with peripheral artery disease

2018 ◽  
Vol 15 (6) ◽  
pp. 504-510 ◽  
Author(s):  
Lars Richter ◽  
Eva Freisinger ◽  
Florian Lüders ◽  
Katrin Gebauer ◽  
Matthias Meyborg ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Type 1 Diabetes Mellitus ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease

Background: The prevalence of diabetes mellitus and its associated complications such as peripheral artery disease is increasing worldwide. We aimed to explore the distinct impact of type 1 diabetes mellitus and type 2 diabetes mellitus on treatment and on short- and long-term outcome in patients with peripheral artery disease. Methods: Retrospective analysis of anonymized data of hospitalized patients covered by a large German health insurance. Assessment of patient’s characteristics (comorbidities, complications, etc.) and outcome using multivariable Cox regression and Kaplan–Meier curves. Results: Among 41,702 patients with peripheral artery disease, 339 (0.8%) had type 1 diabetes mellitus and 13,151 (31.5%) had type 2 diabetes mellitus. Patients with diabetes mellitus had more comorbidities and complications than patients without diabetes mellitus ( p < 0.001). Type 1 diabetes mellitus patients exhibited the highest risk for limb amputation at 4-year follow-up (44.6% vs 35.1%, p < 0.001), while type 2 diabetes mellitus patients had higher mortality than type 1 diabetes mellitus (43.6% vs 31.0%, p < 0.001). Conclusion: Although the fraction of type 1 diabetes mellitus among patients with peripheral artery disease and diabetes mellitus is low, it represents a subset of patients being at particular high risk for limb amputation. Research focused on elaborating the determinants of limb amputation and mortality in peripheral artery disease patients with diabetes mellitus is warranted to improve the poor prognosis of these patients.

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