Association between diabetic retinopathy and diabetic foot ulcer in patients with diabetes: A meta‐analysis

Abstract

This study aimed to explore the relationship between diabetic retinopathy (DR) and diabetic foot ulcers (DFUs) to provide evidence for the prevention of diabetic complications. PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang Data databases were searched from their inception until March 2023 for studies on the relationship between DR and DFU. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. The meta‐analysis was performed using the RevMan 5.3 software. Eleven articles referring to 10 208 patients were included, of whom 2191 patients had DFU and 8017 patients did not have DFU. The meta‐analysis results showed that DR significantly increased the incidence of DFU (47.94% vs. 16.38%; OR, 4.13; 95% CI, 2.33–7.33; p < 0.001). The results of this study suggest that patients with DR have a higher risk of developing DFU, highlighting the importance of regular screening for these two complications to prevent serious adverse outcomes of diabetes. However, further high‐quality studies are required to validate the conclusions of the present study.

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta‐analysis of randomized controlled trials

“…In a recent meta-analysis of 25 RCTs published up to July 2023, Li et al reported that the use of CHM combined with negative pressure wound therapy for DFU increased the overall effectiveness and ulcer healing rate, as well as reduced the ulcer healing time and post-treatment ulcer area. 36 In another metaanalysis of 26 RCTs published in Chinese (n = 24) and English (n = 2) between 2011 and 2017, Wang et al indicated that conventional therapies plus the use of CHM (i. e. orally, topically or combined) may increase the CUH rate of patients with DFU about twice compared with the conventional therapies alone. Also, their systematic F I G U R E 5 Summary of the authors' judgments about the risk of bias domains within the 28 included randomized controlled trials on the effect of topical and oral administrations of herbal products on the healing of diabetic foot ulcer.…”

“…[27][28][29][30] On the contrary, reviews that performed a meta-analysis or comprehensive synthesis included only studies conducted in China or evaluated Chinese Herbal Medicines (CHM), which may limit the generalizability and applicability of their findings. [31][32][33][34][35][36][37] Yet, recent randomized controlled trials (RCTs) performed in different regions have reported inconsistent findings regarding the potential efficacy of herbal medications in healing DFU. Some studies noted no significant difference in ulcer parameters between treatment and routine care groups, [38][39][40][41][42][43][44][45][46] while others reported the promising effects of herbal preparations on treating DFU.…”