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Optical Angiography at Diabetes
Published in Andrey V. Dunaev, Valery V. Tuchin, Biomedical Photonics for Diabetes Research, 2023
Dan Zhu, Jingtan Zhu, Dongyu Li, Tingting Yu, Wei Feng, Rui Shi
Diabetic foot ulcer is one of the most common complications in diabetic patients. Microvascular reactive damage will lead to the progression of diabetic foot ulcer. Jan et al. [67] used LDF to measure the amount of skin blood perfusion on the first metatarsus bone under mechanical stress (300 mmHg) and rapid thermal stress (42°C) in humans, and further evaluated metabolic, neurogenic, and myogenic responses by wavelet analysis. Results showed that metabolic neurogenic and myogenic responses to thermal stimulation were significantly reduced in diabetic patients, especially the neurogenic and myogenic control during the first vasodilation, and metabolism during the second vasodilation. In diabetic patients, myogenic control of mechanical stress stimulation was significantly reduced during reactive hyperemia. Such results suggested that diabetes would cause metabolic neurogenic and myogenic control disorders, leading to microvascular dysfunction. Therefore, the response of microvessels to locally applied mechanical and thermal stresses may be used to evaluate the risk of diabetic foot ulcers.
Potential of Thermal Imaging to Detect Complications in Diabetes
Published in U. Snekhalatha, K. Palani Thanaraj, Kurt Ammer, Artificial Intelligence-Based Infrared Thermal Image Processing and Its Applications, 2023
U. Snekhalatha, K. Palani Thanaraj, Kurt Ammer
DF ulcer is a prevalent complication of diabetes disease that leads to hospitalization and medical care. DF ulcer is often caused by uncontrolled high levels of glucose concentration in the body that leads to the damage of blood vessels, especially in the foot regions. This condition leads to a state of pain or numbness in the foot regions thus leading to peripheral neuropathy. Patients unware of the foot problems could lead to stress in the feet which might cause callus, burns, or cuts. These tissue conditions if not treated in time, could lead to foot ulcers. Severe conditions of foot ulcers require treatments such as amputation of the parts of the foot or the lower limb. The rate at which amputations are performed in the diabetic population is typically 10–20 times the general population. The incidence of a diabetic foot condition that leads to amputation is around 1.5–3.5 per 1000 persons per year. So, proper management of diabetic foot is necessary for better patient care.
Management of diabetic foot
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Venu Kavarthapu, Raju Ahluwalia
Surgical management has been a key component of care in the management of diabetic foot disorders for over the past 70 years (18). The initial focus of surgery was on infection control, but recently functional limb salvage/reconstruction procedures have successfully been added. It is critical that this service be delivered by an MDfT, which includes a diabetologist, podiatrist, orthotist, wound care specialist, orthopaedic surgeon, vascular surgeon, plastic surgeon, microbiologist and radiologist (Figure 19.1). The common conditions the foot and ankle surgeons are expected to deliver the service as part of an MDfT include the following.
Effect of an educational intervention based on the Theory of Planned Behaviour in type 2 diabetic patients at a foot and eye care practice
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
B Pezeshki, S Orangi, SM Kashfi, P Afzali Harsini, F Mohammadkhah, A Khani Jeihooni
Diabetes is one of the most prevalent chronic diseases on a global scale.1 Due to the expanding number of affected individuals and the disease’s severity, these individuals should seek immediate medical assistance.2 Lack of precise blood glucose monitoring has been identified as a major issue for diabetics.3,4 According to the World Health Organization (WHO), diabetes affects over 346 million people globally. Without intervention, this figure is anticipated to more than double by 2030.5 By 2030, it is anticipated that 9.2 million Iranians will have diabetes.6 Diabetes patients are at an increased risk of developing acute and fatal complications (diabetic retinopathy, peripheral neuropathy, myocardial infarction, peripheral vascular disease, end-stage renal disease, and diabetes-related foot problems and amputation) due to poor blood sugar control.7 In the absence of therapy, diabetic foot is one of the most serious and debilitating complications of diabetes, resulting in infection, soft-tissue infection or necrosis, and amputation.8 Jordan believes that with attentive care, 80–85% of diabetic foot amputations can be avoided. Optimal diabetic foot management entails doing daily self-foot inspections, frequently washing and drying feet, avoiding walking barefoot, using orthopaedic shoes, clipping toenails straight across, avoiding manipulation of calluses and corns, and consulting a doctor on a regular basis.9
Effect of leukocyte-platelet fibrin-rich wound reconstruction followed by full-thickness skin grafting in the treatment of diabetic foot Wagner grade 4 ulcer gangrene (toe area)
Published in Platelets, 2023
Yuqi Wang, Yanyan Wang, Xiaotao Wang, Yi Zhao, Siyuan Ruan, Hong Cao
Diabetic foot is one of the most serious complications of diabetes and the leading cause of nontraumatic amputation. According to statistics, the total incidence of diabetic foot ulcers in the world is approximately 6.3%, and approximately 25% of patients have ulcer wounds that will not heal for the rest of their lives. At the same time, the probability of ulcer recurrence after ulcer healing is as high as 60%, and the extremely high recurrence rate of ulcers also increases the risk of amputation [1,2]. The gradual subsidence of limb sensation also makes the affected limb vulnerable to trauma but unable to be treated in time, which aggravates foot ulcers; such trauma includes friction from shoes, impact and crushing from objects, scalding, and even burns, which especially affect the toes of the diabetic foot [3,4]. In the most commonly used Wagner classification of diabetic foot ulcers, localized gangrene of the toes, heels or dorsum of the forefoot (grade 4) is second only to gangrene of the affected limb (grade 5) and is an extremely difficult wound to manage. The appearance of localized gangrene marks the destruction of the local blood supply and irreversible necrosis of soft tissue structures, often accompanied by local infection and soft tissue defects (mostly combined with trauma). If not handled properly, this condition can easily develop into larger areas of ulcers and gangrene and eventually lead to amputation (e.g., toe amputation) [1,5].
Predictive factors and nomogram to evaluate the risk of below-ankle re-amputation in patients with diabetic foot
Published in Current Medical Research and Opinion, 2022
Wentong Dai, Yuan Li, Zexin Huang, Cai Lin, Xing-xing Zhang, Weidong Xia
Consecutive patients diagnosed with diabetic foot and underwent amputation from 1st January 2015 to 31st December 2019 in the First Affiliated Hospital of Wenzhou Medical University, China, were identified. The inclusion criteria for our study were: (a) patients diagnosed with type 2 diabetes and diabetic foot; (b) patients who had undergone amputation (toe and foot); (c) patients with at least one year of follow-up. Type 2 diabetes mellitus was diagnosed in accordance with the World Health Organization criteria. The diagnosis of diabetic foot was based on the diagnostic criteria of the World Health Organization18. The exclusion criteria were: (a) patients diagnosed with any type of cancer; (b) patients with incomplete and inaccurate baseline data, results of laboratory or case history (e.g. missing serum albumin); (c) patients failed to be followed up or died within 1 year; (d) patients had undergone major amputation (above and below knee amputation). Only patients with toe or foot amputations below the ankle were included in the study. Because the overall proportion of patients with major amputations was small, the inclusion of these patients could have skewed the study significantly. The ethical committee of the First Affiliated Hospital of Wenzhou Medical University approved this study protocol (No. 2020-116).