Differences between national and international guidelines for the management of diabetic foot disease

Parker, Christina; Netten, Jaap J. van; Parker, Tony J.; Jia, Limin; Corcoran, Heidi; Garrett, Michele; Kwok, Ching Fai; Nather, Aziz; Que, Ma. Teresa; Srisawasdi, Gulapar; Wraight, Paul R; Lazzarini, Peter A

doi:10.1002/dmrr.3101

Cited by 36 publications

(46 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this measurement is affected by the presence of both macrovascular and microvascular disease and neuropathy. It can be used to predict wound healing and amputation but there is no standardization of the technique, there is high variation in the repeatability of the measurement within and between individuals, it is less reliable in the presence of oedema and results vary from laboratory to laboratory …”

Section: Methods For Assessment Of Microangiopathy In the Diabetic Footmentioning

confidence: 99%

Microangiopathy: Is it relevant to wound healing in diabetic foot disease?

Sharma

Schaper

Rayman³

2019

Diabetes Metabolism Res

View full text Add to dashboard Cite

Chronic diabetic complications – both microvascular and macrovascular – have become serious health issues with their increasing prevalence paralleling the dramatic rise of the diabetic population worldwide. Of these complications, foot disease is a major cause of morbidity and mortality, consuming more health care resource than all other complications combined. Diabetic polyneuropathy and peripheral vascular disease constitute the two main risk factors, with trauma and foot infection being the most important initiating factors and contributors to delayed healing. Intracellular oxidative stress mediated by hyperglycaemia along with hypertension, dyslipidaemia and smoking constitute the main pathological processes in the aetiology of both macrovascular and microvascular disease. Whilst the former remains the major cause of overall mortality in diabetes, the role of microangiopathy in the pathogenesis of diabetes foot disease and its contribution to delayed wound healing in diabetes has yet to be fully understood and indeed continues to be debated. This article will review the key findings to date on structural and functional microvascular abnormalities in the diabetic foot skin and consider their contribution to impaired would healing.

show abstract

Section: Methods For Assessment Of Microangiopathy In the Diabetic Footmentioning

confidence: 99%

Microangiopathy: Is it relevant to wound healing in diabetic foot disease?

Sharma

Schaper

Rayman³

2019

Diabetes Metabolism Res

View full text Add to dashboard Cite

show abstract

“…It is also important that governments in the region attempt to harmonize their guidelines with other international guidelines. Indeed a recent analysis showed that six national guidelines of Western Pacific nations were at best only partially similar to 53% of the recommendations by the International Working Group on the Diabetic Foot; specifically 42% for wound healing, 40% for infection, 40% for peripheral artery disease and just 20% for offloading 46 .…”

Section: Recommendation For the Diagnosis Of Peripheral Neuropathy Inmentioning

confidence: 99%

Diagnosing peripheral neuropathy in South‐East Asia: A focus on diabetic neuropathy

Malik

Andag-Silva

Dejthevaporn

et al. 2020

J of Diabetes Invest

View full text Add to dashboard Cite

Burning and stabbing pain in the feet and lower limbs can have a significant impact on the activities of daily living, including walking, climbing stairs and sleeping. Peripheral neuropathy in particular is often misdiagnosed or underdiagnosed because of a lack of awareness amongst both patients and physicians. Furthermore, crude screening tools, such as the 10‐g monofilament, only detect advanced neuropathy and a normal test will lead to false reassurance of those with small fiber mediated painful neuropathy. The underestimation of peripheral neuropathy is highly prevalent in the South‐East Asia region due to a lack of consensus guidance on routine screening and diagnostic pathways. Although neuropathy as a result of diabetes is the most common cause in the region, other causes due to infections (human immunodeficiency virus, hepatitis B or C virus), chronic inflammatory demyelinating polyneuropathy, drug‐induced neuropathy (cancer chemotherapy, antiretrovirals and antituberculous drugs) and vitamin deficiencies (vitamin B1, B6, B12, D) should be actively excluded.

show abstract

“…Instead, clinical judgement and foot shape are taken into account, which vary in method, in addition to a wide variety of materials being used . Therefore, due to large variability within both research and clinical practice, there are no standardised protocols and so footwear development is often described as more of an art than a science …”

Section: Plantar Offloading Interventions For the At‐risk Footmentioning

confidence: 99%

The role of foot pressure measurement in the prediction and prevention of diabetic foot ulceration—A comprehensive review

Chatwin

Abbott

Boulton

et al. 2019

Diabetes Metabolism Res

View full text Add to dashboard Cite

The predominant risk factor of diabetic foot ulcers (DFU), peripheral neuropathy, results in loss of protective sensation and is associated with abnormally high plantar pressures. DFU prevention strategies strive to reduce these high plantar pressures.Nevertheless, several constraints should be acknowledged regarding the research supporting the link between plantar pressure and DFUs, which may explain the low prediction ability reported in prospective studies. The majority of studies assess vertical, rather than shear, barefoot plantar pressure in laboratory-based environments, rather than during daily activity. Few studies investigated previous DFU location-specific pressure. Previous studies focus predominantly on walking, although studies monitoring activity suggest that more time is spent on other weight-bearing activities, where a lower "peak" plantar pressure might be applied over a longer duration.Although further research is needed, this may indicate that an expression of cumulative pressure applied over time could be a more relevant parameter than peak pressure. Studies indicated that providing pressure feedback might reduce plantar pressures, with an emerging potential use of smart technology, however, further research is required. Further pressure analyses, across all weight-bearing activities, referring to location-specific pressures are required to improve our understanding of pressures resulting in DFUs and improve effectiveness of interventions.

show abstract

Differences between national and international guidelines for the management of diabetic foot disease

Cited by 36 publications

References 44 publications

Microangiopathy: Is it relevant to wound healing in diabetic foot disease?

Microangiopathy: Is it relevant to wound healing in diabetic foot disease?

Diagnosing peripheral neuropathy in South‐East Asia: A focus on diabetic neuropathy

The role of foot pressure measurement in the prediction and prevention of diabetic foot ulceration—A comprehensive review

Contact Info

Product

Resources

About