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 Benefits of Hydrocolloid-Absorbent Dressings in “Diabetic Foot” Therapy

2020 ◽  
Vol 25 (2) ◽  
pp. 22-25
Author(s):  
Denisa Tănăsescu
Keyword(s):  
Diabetic Foot ◽  
Conservative Therapy ◽  
Therapeutic Option ◽  
Therapeutic Education ◽  
Varicose Ulcer ◽  
Patients With Diabetes ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
The Right

AbstractThe incidence of diabetes is constantly increasing, so in 2014 about 8, 5% of adults over the age of 18 had diabetes worldwide. Also mortality in patients with diabetes is increased, only in 2015 being the direct cause for 1.6 million deaths worldwide. Worldwide, there are currently 425 million people living with diabetes; by 2045, 629 million people are expected to have diabetes. The authors present the case of patient I.A. 46 years old, male, from urban area, known with type 2 diabetes mellitus insulinotreated, secondary to acute pancreatitis, necrotico-haemorrhagic, operated on antecedents, which is presented in our service accusing spontaneous sensitivity and palpation of the lower limb right, premaleolar ulceration on the inner face of the lower right limb, with Celsian signs at this level, paresthesias at the level of the right leg, muscular weakness, weight loss. Alternative absorbent-hydrocolloid therapy is a feasible therapeutic option for patients with varicose ulcer wounds, especially in those with diabetic background. The combination of targeted antibiotic therapy, systemic treatment, local surgical treatment followed by local colloidal-absorbent treatment has very good results in a much shorter time than conventional, conservative therapy. Prophylaxis of any “diabetic foot” disease is extremely important. Therapeutic education is a major role in preventing the complications of diabetes. The diabetic patient should be trained and learned in order to prevent problems that may occur in the foot.

Biomechanics of the foot in diabetes mellitus. Some theoretical considerations

1998 ◽  
Vol 88 (6) ◽  
pp. 285-289 ◽  
Author(s):  
CB Payne
Keyword(s):  
Diabetes Mellitus ◽  
Lower Extremity ◽  
Diabetic Foot ◽  
Theoretical Concepts ◽  
Plantar Pressures ◽  
Patients With Diabetes ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Biomechanics Of The Foot ◽  
Theoretical Considerations

Although diabetes mellitus is a biochemical disease, it has biomechanical consequences for the lower extremity. Numerous alterations occur in the function of the foot and lower extremity in people with diabetes. This article evaluates biomechanical alterations of the foot in the presence of neuropathy in patients with diabetes in the context of several theoretical concepts. Further study of these hypotheses will result in a better understanding of how diabetes causes elevated plantar pressures and the potential of strategies to prevent these changes so that the burden of diabetic foot disease can be reduced.

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

scholarly journals Clinician Assessment Tools for Patients with Diabetic Foot Disease: A Systematic Review

2020 ◽  
Vol 9 (5) ◽  
pp. 1487
Author(s):  
Raúl Fernández-Torres ◽  
María Ruiz-Muñoz ◽  
Alberto J. Pérez-Panero ◽  
Jerónimo C. García-Romero ◽  
Manuel Gónzalez-Sánchez
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Assessment Tools ◽  
Patients With Diabetes ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Clinician Assessment

The amputation rate in patients with diabetes is 15 to 40 times higher than in patients without diabetes. To avoid major complications, the identification of high-risk in patients with diabetes through early assessment highlights as a crucial action. Clinician assessment tools are scales in which clinical examiners are specifically trained to make a correct judgment based on patient outcomes that helps to identify at-risk patients and monitor the intervention. The aim of this study is to carry out a systematic review of valid and reliable Clinician assessment tools for measuring diabetic foot disease-related variables and analysing their psychometric properties. The databases used were PubMed, Scopus, SciELO, CINAHL, Cochrane, PEDro, and EMBASE. The search terms used were foot, ankle, diabetes, diabetic foot, assessment, tools, instruments, score, scale, validity, and reliability. The results showed 29 validated studies with 39 Clinician assessment tools and six variables. There is limited evidence on all of the psychometric characteristics of the Clinician assessment tools included in this review, although some instruments have been shown to be valid and reliable for the assessment of diabetic neuropathy (Utah Early Neuropathy Scale or UENS); ulceration risk (Queensland High Risk Foot Form or QHRFF); diabetic foot ulcer assessment, scoring, and amputation risk (Perfusion, extent, depth, infection and sensation scale or PEDIS and Site, Ischemia, Neuropathy, Bacterial Infection, and Depth score or SINBAD); and diabetic foot ulcer measurement (Leg Ulcer Measurement Tool LUMT).

scholarly journals Diabetic Foot Disease during the COVID-19 Pandemic

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 97
Author(s):  
Andrew J. M. Boulton
Keyword(s):  
Diabetic Foot ◽  
Digital Health ◽  
Foot Ulcers ◽  
Illustrative Case ◽  
Hands On ◽  
The World ◽  
Case Vignettes ◽  
Foot Problems ◽  
Diabetic Foot Disease ◽  
Foot Disease

Throughout 2020, the COVID-19 pandemic has had a major impact on the care of non-communicable diseases across the world and diabetes is no exception. Whereas many branches of medicine have adapted to telemedicine, this is difficult and challenging for the diabetic foot which often requires “hands on” treatment. This review covers the challenges that have faced clinicians across the world in the management of complex diabetic foot problems and also includes some illustrative case vignettes which show how it is possible to manage foot ulcers without the usual access to laboratory and radiological testing. There is no doubt that the COVID-19 experience when handling diabetic foot problems will likely transform our approach to the management of diabetic foot disease especially in the areas of digital health and smart technology.

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.

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