Early changes in the skin microcirculation and muscle metabolism of the diabetic foot

Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: The Fremantle Diabetes Study

“…The risk of an ulcer and subsequent LEA increases when there is also loss of sensation and mechanical deformity associated with neuropathy and PAD [36]. Our data are, therefore, consistent with a plausible multifactorial causal pathway involving PAD, neuropathy and local microvascular changes in the foot [34,36,37]. As a likely reflection of diabetes-specific risk factors such as microangiopathy, we found that the incidence of first-ever minor amputations was higher than that of first-ever major amputations, in contrast to the findings reported for general populations [3].…”

“…There is evidence that skin oxygenation, muscle metabolism and wound healing are impaired by microcirculatory changes in the diabetic foot [34,35]. The risk of an ulcer and subsequent LEA increases when there is also loss of sensation and mechanical deformity associated with neuropathy and PAD [36].…”

An intelligent telemedicine system for detection of diabetic foot complications

“…Several studies have been conducted to implement hyperspectral imaging for monitoring diabetic neuropathy [55], for monitoring and predicting ulcer healing process [56][57][58], and for assessing the risk for ulceration formation [59]. Beyond these three options for diabetic foot management, an intelligent monitoring system should also be capable of automatic recognition of ulcers and its pre-signs and to be able to discriminate these complications from the healthy skin.…”

“…It measures the spectral data of the entire target area. The measurements are rendered into image form, providing a non-contact and noninvasive diagnosis tool to monitor diabetic neuropathy [55], to assess the risk for ulceration formation [59], and to predict ulcer healing [56,57]. Most of the pioneer studies followed the 'analytical approach' [96], which seeks to deconstruct the reflectance spectra into biologically and physically meaningful factors, such as a map of tissue oxygenation.…”

“…Impairments in these features play an important role in the development of diabetic foot ulcerations and their subsequent failure to heal [48]. Based on these features, studies have been conducted with MHSI to assess the risk for ulcer formation [59], to monitor diabetic neuropathy [55], and to predict ulcer healing [57]. Besides these three options, an intelligent monitoring system should also be capable to automatically recognize ulcers and pre-signs of ulceration, such as abundant callus formation, inflammation and blisters, and discriminate these skin spots from healthy skin.…”