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

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

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.

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.

Critical limb ischaemia in diabetes: definition, assessment, prognosis

VASA ◽  
2001 ◽  
Vol 30 (Supplement 58) ◽  
pp. 21-27
Author(s):  
Luther
Keyword(s):  
Diabetic Foot ◽  
Laboratory Tests ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Clinical Use ◽  
Arterial Reconstruction ◽  
Arterial Circulation ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Fontaine Classification

In diabetic foot disease, critical limb ischaemia (CLI) cannot be precisely described using established definitions. For clinical use, the Fontaine classification complemented with any objective verification of a reduced arterial circulation is sufficient for decision making. For scientific purposes, objective measurement criteria should be reported. Assessment of CLI should rely on the physical examination of the limb arteries, complemented by laboratory tests like the shape of the PVR curve at ankle or toe levels, and arteriography. The prognosis of CLI in diabetic foot disease depends on the success of arterial reconstruction. The best prognosis for the patients is with a preserved limb. Reconstructive surgery is the best choice for the majority of patients.

Current Concepts in Diabetic Microvascular Dysfunction

2006 ◽  
Vol 96 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Javier La Fontaine ◽  
Lawrence B. Harkless ◽  
Christian E. Davis ◽  
Marque A. Allen ◽  
Paula K. Shireman
Keyword(s):  
Diabetic Foot ◽  
Vascular System ◽  
Microvascular Dysfunction ◽  
Diabetic Macroangiopathy ◽  
Patients With Diabetes ◽  
Foot Problems ◽  
Control Of Diabetes ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Pathologic Processes

Microvascular dysfunction is an important component of the pathologic processes that occur in diabetic foot disease. The endothelial abnormalities observed in patients with diabetes mellitus are poorly understood, and evidence suggests that endothelial dysfunction could be involved in the pathogenesis of diabetic macroangiopathy and microangiopathy. With the advent of insulin replacement in the early 1900s and increased efforts toward metabolic control of diabetes, long-term complications of this disease have become apparent. These late-term complications are primarily disorders of the vascular system. This article reviews the process of microvascular dysfunction and how it may relate to the pathogenesis of diabetic foot problems. (J Am Podiatr Med Assoc 96(3): 245–252, 2006)

scholarly journals Association of anaemia in patients with diabetic foot disease

2012 ◽  
Vol 10 (8) ◽  
pp. S105
Author(s):  
Mustafa Khanbhai ◽  
Stavros Loukogeorgakis ◽  
Steven Hurel ◽  
Richards Toby
Keyword(s):  
Diabetic Foot ◽  
Diabetic Foot Disease ◽  
Foot Disease

Association Between the Diabetes mellitus Duration and the Severity of Diabetic Foot Disease in Hospitalized Patients in Latin America

2021 ◽  
pp. 153473462110632
Author(s):  
Belissa Bedriñana-Marañón ◽  
Maria Rubio-Rodríguez ◽  
Marlon Yovera-Aldana ◽  
Eilhart Garcia-Villasante ◽  
Isabel Pinedo-Torres
Keyword(s):  
Diabetes Mellitus ◽  
Latin America ◽  
Diabetic Foot ◽  
Poisson Regression ◽  
Hospitalized Patients ◽  
Bivariate Analysis ◽  
Severe Injuries ◽  
History Of ◽  
Diabetic Foot Disease ◽  
Foot Disease

The objective was to determine the association between a diabetes mellitus duration greater than 10 years and the severity of diabetic foot in hospitalized patients in Latin America. Analytical, observational, and retrospective study based in secondary databases. Patients older than 18 years with diagnosis of diabetes mellitus (DM) and hospitalized for any causes were included. The independent and dependent variables were having more than 10 years of diagnosis of DM and the severity of the diabetic foot disease (Wagner> = 2), respectively. A crude Poisson regression analysis was performed to obtain prevalence rates adjusted to confounders. Male gender was 54.8% and the median age was 62 years. In the group with more than10 years of disease (n = 903) 18% (n = 162) had severe injuries. We performed two Poisson regression analyzes, one of which included the entire sample; and in the other, only patients with some degree of ulcer were included at the time of evaluation (Wagner > = 1). In the first analysis the PR was 1.95 ( p < 0.01) adjusted for the significant variables in the bivariate analysis and in the second analysis the PR was 1.18 ( p < 0.01) adding to the adjustment the days of injury prior to hospitalization and the location of the ulcer. We conclude that in patients with more than 10 years of diabetes mellitus, diabetic foot injuries are more severe, regardless type of diabetes, gender, age, history of amputation and days of injury prior to hospitalization for inpatients in Latin America.

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