Management of diabetic foot ulcers and the challenging points: An endocrine view

Doğruel, Hakan; Aydemir, Mustafa; Balcı, Mustafa Kemal

doi:10.4239/wjd.v13.i1.27

Cited by 41 publications

(34 citation statements)

References 59 publications

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“…Diabetic foot is the most common chronic complication of diabetes. Its pathological manifestations are arteriosclerosis, occlusion, and neuropathy in the lower extremities, which leads to local accidental injury of the skin tissue of the foot or postoperative wounds that are difficult to heal and gradually form ulcers, resulting in amputation or even death [ 8 , 32 ]. Diabetic foot not only reduces the quality of life, but also creates a huge economic burden, including direct and indirect costs of DF care and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetic foot not only reduces the quality of life, but also creates a huge economic burden, including direct and indirect costs of DF care and treatment. The traditional methods of treating diabetic foot are mainly systematic medical treatment, lower extremity surgical blood flow reconstruction, and wound debridement care [ 8 , 12 ]. Drugs cannot fundamentally solve arterial stenosis, occlusion, and ischemia.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update

et al. 2022

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Background Diabetic foot (DF) is one of the most common and serious complications of diabetes mellitus (DM), which brings great psychological and economic pressure to patients. This study aimed to evaluate the efficacy of stem cells in the treatment of diabetic foot. Methods All relevant studies in Cochrane, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and WanFang databases were systematically searched for meta-analysis. The outcomes consisted of ulcer or wound healing rate, amputation rate, new vessels, ankle–brachial index (ABI), transcutaneous oxygen pressure (TcPO2), pain-free walking distance, and rest pain score. Dichotomous outcomes were described as risk ratios (RR) with 95% confidence intervals (CIs), while continuous data were presented as standardized mean differences (SMDs) with 95% CIs. Statistical analysis was performed with RevMan 5.3 software. Results A total of 14 studies with 683 participants were included in the meta-analysis. Meta-analysis showed that stem cell therapy was more effective than conventional therapy in terms of ulcer or wound healing rate [OR = 8.20 (5.33, 12.62)], improvement in lower extremity ischemia(new vessels) [OR = 16.48 (2.88, 94.18)], ABI [MD = 0.13 (0.04, 0.08)], TcO2[MD = 4.23 (1.82, 6.65)], pain-free walking distance [MD = 220.79 (82.10, 359.48)], and rest pain score [MD = − 1.94 (− 2.50, − 1.39)], while the amputation rate was significantly decreased [OR = 0.19 (0.10, 0.36)]. Conclusions The meta-analysis of the current studies has shown that stem cells are significantly more effective than traditional methods in the treatment of diabetic foot and can improve the quality of life of patients after treatment. Future studies should conduct large-scale, randomized, double-blind, placebo-controlled, multicenter trials with high-quality long-term follow-up to demonstrate the most effective cell types and therapeutic parameters for the treatment of diabetic foot.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Diabetic foot is the most common chronic complication of diabetes. Its pathological manifestations are arteriosclerosis, occlusion and neuropathy in the lower extremities, which leads to local accidental injury of the skin tissue of the foot or postoperative wounds that are difficult to heal and gradually form ulcers, resulting in amputation or even death [8,32]. Diabetic foot not only reduces quality of life, but also creates a huge economic burden, including direct and indirect costs of DF care and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetic foot not only reduces quality of life, but also creates a huge economic burden, including direct and indirect costs of DF care and treatment. The traditional methods of treating diabetic foot are mainly systematic medical treatment, lower extremity surgical blood flow reconstruction and wound debridement care [8,12]. Drugs cannot fundamentally solve arterial stenosis, occlusion, and ischemia.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of Stem cell therapy for Diabetic Foot: a meta-analysis update

Sun

Zhao

Zhang

et al. 2022

Preprint

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Background: Diabetic foot (DF) is one of the most common and serious complications of diabetes mellitus (DM), which brings great psychological and economic pressure to patients. This study aimed to evaluate the efficacy of stem cells in the treatment of diabetic foot. Methods: All relevant literatures in Cochrane, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang databases were systematically searched for meta-analysis. The outcomes consisted of ulcer or wound healing rate, amputation rate, new vessels, ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), pain-free walking distance, and rest pain score. Dichotomous outcomes were described as risk ratios (RR) with 95% confidence intervals (CIs), while continuous data were presented as standardized mean differences (SMDs) with 95% CIs. Statistical analysis was performed with RevMan 5.3 software. Results: A total of 14 studies with 683 participants were included in the meta-analysis. Meta-analysis showed that stem cell therapy was more effective than conventional therapy in terms of ulcer or wound healing rate [OR =8.20 (5.33, 12.62)], improvement of lower extremity ischemia(new vessels) [OR=16.48 (2.88, 94.18)], ABI [MD=0.13 (0.04, 0.08)], TcO2[MD=4.23 (1.82, 6.65)], pain-free walking distance [MD =220.79 (82.10, 359.48)], and rest pain score [MD =-1.94 (-2.50, -1.39)], while the amputation rate was significantly decreased [OR =0.19 (0.10, 0.36)]. Conclusions: The meta-analysis of the current studies has shown that stem cells are significantly more effective than traditional methods in the treatment of diabetic foot, and can improve the quality of life of patients after treatment. Future studies should conduct large-scale, randomized, double-blind, placebo-controlled, multicenter trials with high-quality long-term follow-up to demonstrate the most effective cell types and therapeutic parameters for the treatment of diabetic foot.

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“…The prognosis of diabetes is perturbing due to long-term hyperglycemia leading to chronic damage and dysfunction of various tissues, especially the eyes, kidneys, heart, blood vessels and nerves ( 4 ). Diabetic foot is one of the most difficult complications to treat among all the complications of diabetes ( 5 ). Diabetic foot ulcers (DFU) are associated with high morbidity and mortality globally ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Attitudes, and Practices Associated With Diabetic Foot Prevention Among Rural Adults With Diabetes in North China

Jia

Wang

Cheng

2022

Front. Public Health

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BackgroundThe diabetic foot is a global threat to public health because it can result in infection and amputation, as well as cause the patient to experience considerable pain and incur financial costs. The condition of patients with diabetic foot in North China is distinguished by more severe local ulcers, a worse prognosis, and a longer duration of disease than that of patients with diabetic foot in the south. Through appropriate preventive measures, the diabetic foot can be effectively avoided. This study assesses the existing knowledge, attitudes and practices associated with diabetic foot prevention among adults with diabetes living in rural areas of North China.MethodThis cross-sectional survey included 1,080 rural adults from North China, cluster sampled 12 villages and surveyed diabetic patients without diabetic foot who participated in community diabetes management. The self-administered knowledge and attitude questionnaire and the Chinese version of the Nottingham Assessment of Functional Foot-care Questionnaire were used.ResultOf the 1,080 subjects, 51.6% received moderate knowledge scores, 63.9% had a positive attitude and 71.4% received poor practice scores. In terms of knowledge, parameters of knowledge about foot examinations and treatment of foot problems showed the lowest scores. In terms of practice, in line with the results of the low knowledge score, parameters of the pursuit of medical treatment for foot problems and routine foot examinations were associated with the lowest scores. Multiple regression analysis revealed that participants who were current smokers (β: −0.049, 95% CI: −0.088 to −0.011) had lower knowledge scores than those who never smoke; participants who were current smokers (β: −0.818, 95% CI: −1.067 to −0.569) and past smokers (β: −0.299, 95% CI: −0.485 to −0.112) had lower attitude scores than those who had never smoked; participants who had higher knowledge scores (β: 1.964, 95% CI: 1.572–2.356) achieved higher scores on attitudes; women had better practice scores than men (β: 0.180, 95% CI: 0.122–0.239); patients with a long diabetes duration (6–10 years) had better practice scores than those who had a short diabetes duration (<2 years; β: 0.072, 95% CI: 0.012–0.131). Knowledge (β: 0.130, 95% CI: 0.001–0.258) and attitudes (β: 0.268, 95% CI: 0.249–0.287) were significantly associated with good practices.ConclusionsIncreasing knowledge regarding diabetic foot would help instill positive attitudes and cultivate better practices toward diabetic foot prevention. The results of this study may help guide future promotional resources to those groups most in need, which may help lower the incidence of diabetic foot among adults in North China.

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Management of diabetic foot ulcers and the challenging points: An endocrine view

Cited by 41 publications

References 59 publications

Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update

Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update

Effectiveness and safety of Stem cell therapy for Diabetic Foot: a meta-analysis update

Knowledge, Attitudes, and Practices Associated With Diabetic Foot Prevention Among Rural Adults With Diabetes in North China

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