High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study

Prompers, L.; Huijberts, M. S. P.; Apelqvist, Jan; Jude, Edward B.; Piaggesi, Alberto; Баккер, К.; Edmonds, Michael; Holstein, P.; Jirkovská, Alexandra; Mauricio, Dı́dac; Tennvall, Gunnel Ragnarson; Reike, Heinrich; Spraul, Maximilian; Uccioli, Luigi; Urbančič, V.; Acker, Kristien Van; Baal, Jeff Van; Merode, Frits van; Schaper, Nicolaas C.

doi:10.1007/s00125-006-0491-1

Cited by 801 publications

(672 citation statements)

References 37 publications

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“…[29] More recently, the multicentre EURODIALE study of 1,229 consecutive patients presenting with a new foot ulcer has reported that 58% of the ulcers were infected at presentation, while evidence of infection was present in 82% of patients admitted to hospital. [30] Other important gates of bacterial entry include ingrown toenails, paronychia, and interdigital mycoses. [27,28] Infection is usually polymicrobial, with a mixed picture of gram-positive cocci, accompanied by gram-negative bacteria and anaerobes.…”

Section: The Diabetic Foot: Epidemiology and Pathogenesismentioning

confidence: 99%

The Diabetic Foot in End Stage Renal Disease

et al. 2007

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Diabetic foot lesions remain a major cause of morbidity in patients with renal failure, especially those on dialysis. Foot complications are encountered at a more than twofold frequency in diabetic patients with end-stage renal disease, and the rate of amputations is 6.5-10 times higher in comparison to the general diabetic population. The causal pathways of the diabetic foot in renal failure are multiple and inter-related. Three major pathologies-neuropathy, ischemia, and infection-are the main contributory factors. Increased awareness of this condition and careful clinical examination are indispensable to avoid serious complications. Appropriate management needs to address all contributory factors. Treatment options include revascularization, off-loading to relieve high-pressure areas, and aggressive control of infection. Equally important is the collaboration between health care providers in a multidisciplinary foot care setting. Moreover, patient education on the measures required to achieve both primary and secondary prevention is of great value. Certainly, technical innovations have made considerable progress possible, but there is a need for further improvement to reduce the number of amputations.

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Section: The Diabetic Foot: Epidemiology and Pathogenesismentioning

confidence: 99%

The Diabetic Foot in End Stage Renal Disease

et al. 2007

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“…Diabetics are at increased risk of developing infections, peripheral neuropathy, retinopathy and renal impairment or failure. There is no evidence that diabetic patients with good glycaemic control are more prone to infection than normal subjects [1][2][3]. However, poorly controlled diabetes entails increased susceptibility to skin, urinary tract and lung infections.…”

Section: Introductionmentioning

confidence: 98%

“…Its causes are incompletely understood, but it is clear that the disease is often multifactorial and that both genetic and environmental factors are involved [2]. Approximately 90% of diabetics have type 2 diabetes (non-insulin dependent -NIDDM) and most complications of diabetes are related to vascular impairment [1][2][3][4]. Diabetics are at increased risk of developing infections, peripheral neuropathy, retinopathy and renal impairment or failure.…”

Section: Introductionmentioning

confidence: 99%

The Diabetic Foot

Weledji¹

2015

J Nurs Care

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Diabetic foot infections are a frequent clinical problem. About 50% of diabetic foot infections who have foot amputations die within five years. Properly managed most can be cured, but many patients needlessly undergo amputations because of improper diagnostic and therapeutic approaches. This approach along with vascular assessment help clinical decisions about which patients to hospitalize, which to send for imaging procedures or for whom to recommend surgical interventions. This paper reviewed the natural history of the diabetic foot and assessed the surgical impact of the Infectious Diseases Society of America clinical practice guideline-based care of diabetic foot infections. Keywords: Diabetic foot infection; Neuropathic foot; Ischaemic foot; Risk factors; Medical and surgical management; Prevention MethodsElectronic searches of the medline (PubMed) database, Cochrane library, and science citation index were performed to identify original published studies on the natural history and current management of the diabetic foot. Relevant articles were searched from relevant chapters in specialized texts and all were included.

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“…The EURODALE multicentre study reported PAD in 52.5% of DFUs, and a significantly reduced healing rate with PAD than without (69% vs. 84%, respectively)[5]. Diabetic foot infection (DFI) reportedly occurs in 40.8–58% of DFU cases[5,7] and osteomyelitis in approximately 20% of DFU, with this figure increasing to over 60% in the presence of severe DFI [8]. Furthermore, PAD and DFI have been associated with some of the most adverse outcomes of DFU and can lead to major amputation [9].…”

Section: Introductionmentioning

confidence: 99%

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

Messenger

Masoetsa

Hussain

et al. 2018

Diabetic Foot & Ankle

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Objective: This single-centred study aims to evaluate the incidence, risk factors and treatment outcomes of a podiatry led, evidence-based diabetic foot ulcer (DFU) clinic. Research design and methods: Data from the DFU database and patient electronic health records were retrospectively collected from patients with new DFUs who were referred for treatment to the Department of Podiatry, Dasman Diabetes Institute, Kuwait, from 1 October 2014, to 31 December 2016. Patients were followed-up until healing occurred or until 6 months after the study end date, whichever came first. Results: All data were analysed using IBM SPSS version 24 software. Data were collected from 230 patients with 335 DFUs. Most DFUs (67%) were present for <3 months from the time of the first podiatry appointment. A total of 56% of DFUs were classified as neuropathic. Most (72%) DFUs healed, with a median healing time of 52.0 days. Chronic kidney disease (p = 0.001), retinopathy (p = 0.03), smoking (p = 0.02), ulcer location (p = 0.03), peripheral arterial disease (PAD) (p = 0.004) and osteomyelitis (p = 0.05) were found to have a meaningful association with DFU outcome. The number of days to heal was associated with ulcer classification (p = 0.005), bacterial infection (p = 0.002), osteomyelitis (p = < 0.001) and PAD (p = < 0.001). Conclusions: The incidence of new DFUs in our tertiary clinic is 3.4%. The incidence of diabetic foot ulceration, days to heal, healing rate and the risk factors influencing healing are in accordance with other multidisciplinary facilities with podiatry input.

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High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study

Cited by 801 publications

References 37 publications

The Diabetic Foot in End Stage Renal Disease

The Diabetic Foot in End Stage Renal Disease

The Diabetic Foot

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

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