Morbidity and mortality associated with diabetic foot disease: a 12-month prospective survey of hospital admissions in a single UK centre

Krentz, Andrew J.; Acheson, Peter; Basu, Abhijit; Kilvert, Anne; Wright, Alex; Nattrass, M.

doi:10.1016/s0958-2592(97)90025-0

Cited by 22 publications

(11 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diabetic foot ulcer is an outcome of a complex array of various risk factors such as peripheral neuropathy, peripheral vascular disease, foot deformities, arterial insufficiency, trauma and impaired resistance to infection [ 5 ]. The lifetime risk of a diabetic for developing a foot ulcer can be as high as 25% [ 6 ], with DFUs accounting for more hospital admissions than any other long-term complications of diabetes [ 7 ]. As a result, the rate of lower limb amputations is 6 times higher in diabetic patients compared with non-diabetics [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Technologies to monitor the health of loaded skin tissues

Bader

Worsley

2018

BioMed Eng OnLine

View full text Add to dashboard Cite

There are many situations where the skin and underlying soft tissues are compromised by mechanical loading in the form or pressure, or pressure in combination with shear. If sustained, this can lead to damage in the tissues particularly adjacent to bony prominences, resulting in chronic wounds. An array of bioengineering technologies have been adopted to assess the integrity of loaded soft tissues. This paper aims to review these approaches for the quantification, simulation and early detection of mechanically-induced skin damage. The review considers different measurements at the interface between the skin and support surface/medical device, involving pressure, shear, friction and the local microclimate. The potential of the techniques to monitor the physiological response of the skin to these external stimuli including biophysical measurement devices and sampling of biofluids are critically analysed. In addition, it includes an analysis of medical imaging technologies and computational modelling to provide a means by which tissue deformation can be quantified and thresholds for tissue damage defined. Bioengineering measurement and imaging technologies have provided an insight into the temporal status of loaded skin. Despite the advances in technology, to date, the translation to clinical tools which are robust and cost effective has been limited. There is a need to adapt existing technologies and simulation platforms to enable patients, carers and clinicians to employ appropriate intervention strategies to minimise soft tissue damage.

show abstract

Section: Introductionmentioning

confidence: 99%

Technologies to monitor the health of loaded skin tissues

Bader

Worsley

2018

BioMed Eng OnLine

View full text Add to dashboard Cite

show abstract

“…Approximately 50% of all hospital admissions for diabetic foot complications is attributable to foot ulceration [13], and the cost of treating an ulcer in one foot over a 2-year period following diagnosis (including outpatient and topical wound care in addition to inpatient care) is an estimated $28 000 (US) [10,14]. Furthermore, the rate of lower-limb amputation, which in patients with diabetes is preceded by foot ulceration 70 to 85% of the time [10,15], is 15 times higher in diabetic than in non-diabetic patients, roughly 50% of whom will also eventually require amputation of the contralateral limb [16].…”

Section: Introductionmentioning

confidence: 99%

Vibration perception threshold—a valuable assessment of neural dysfunction in people with diabetes

Garrow¹,

Boulton²

2006

Diabetes Metabolism Res

View full text Add to dashboard Cite

Diabetic peripheral neuropathy (DPN) has been identified as a key element in the causal pathway to foot ulceration and other lower-extremity complications, impaired quality of life and increased mortality. Early detection is essential to optimise effective risk management, including adequate foot care, patient education, and future pharmacological therapy. However, data suggest that screening has been mostly sub-optimal, and many physicians remain unfamiliar with non-invasive screening tests. There is evidence in the literature to suggest that vibration perception threshold (VPT) measures can be used to easily and accurately identify at-risk diabetic patients, including those with early neuropathic deficits. These measures have been used in population-based studies and are associated with an increased risk of severe and expensive outcomes, such as ulcers and amputations. Incorporating VPT testing into clinical practice has the potential to significantly improve the outcomes in patients with DPN, thereby substantially reducing the socio-economic burden of this common and challenging disease.

show abstract

“…36 Foot problems in diabetic patients account for more hospital admissions than any other long-term complications of diabetes and also result in increasing morbidity and mortality. 37,38 The 'diabetic foot syndrome' encompasses a number of pathologies, including neuropathy, peripheral vascular disease, neuroarthropathy, foot ulceration, osteomyelitis and the potentially preventable end-point of amputation. 19 Patients with a diabetic foot can also have many diabetic complications and a multidisciplinary approach is usually necessary.…”

Section: Neuropathic Foot Ulcerationmentioning

confidence: 99%

Recent advances in the diagnosis and management of diabetic neuropathy

Rathur

Boulton

2005

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

The World Health Organisation estimated that in the year 2000, 150 million people had diabetes mellitus, and it is predicted that this number will rise to 366 million by the year 2030. 1 Neuropathy is a common complication of diabetes and is characterised by a progressive loss of peripheral nerve fibres. 2 There are a number of manifestations including both mono-and polyneuropathies. In the diabetic foot, distal sensory polyneuropathy is seen most commonly. However, motor and autonomic fibres may also be involved and combined neuropathies frequently occur. The development of a neuropathy is linked to poor glycaemic control over many years and it increases in frequency with both age and the duration of diabetes. EpidemiologyThe epidemiology and natural history of diabetic neuropathy remain poorly defined. A number of studies have indicated that the prevalence of neuropathy is approximately 30% among diabetic patients attending hospital 3 while lower rates closer to 20% are seen in population-based samples. 4-9 Among the elderly, the prevalence may be as high as 50%. 2,4 It varies from 14% to 63% depending upon the type of population studied and the criteria used to define diabetic neuropathy. 7 In the EURODIAB IDDM Complication Study 10 which included 3250 patients, the overall prevalence of neuropathy in 16 European countries was 28%. In the Rochester Diabetic Neuropathy Study, 8 it affected almost 60% of subjects although it was symptomatic only in about 15%. CausationDespite much intensive research, the pathophysiology remains unclear. The principal theories are of microvascular disease leading to neural hypoxia, and the direct effects of hyperglycaemia on neuronal metabolism. Recently, attempts to unify these two theories have demonstrated abnormalities in nitric oxide metabolism, resulting in altered perineural blood flow and nerve damage. Longitudinal data from the Rochester Study 8 supported the contention that the duration and severity of exposure to hyperglycaemia influenced the severity of the neuropathy. To date no treatment which prevents or reverses its development and progression has been identified. Recently, however, numerous competing or parallel pathological pathways have been shown to intersect and complement each other, thus illuminating potential pharmacological targets. Current research on diabetic neuropathy is focused on oxidative stress, advanced glycation-end products, protein kinase C and the polyol pathway. 2

show abstract

Morbidity and mortality associated with diabetic foot disease: a 12-month prospective survey of hospital admissions in a single UK centre

Cited by 22 publications

References 9 publications

Technologies to monitor the health of loaded skin tissues

Technologies to monitor the health of loaded skin tissues

Vibration perception threshold—a valuable assessment of neural dysfunction in people with diabetes

Recent advances in the diagnosis and management of diabetic neuropathy

Contact Info

Product

Resources

About