Physiological and Pathophysiological Aspects of Diabetic Foot Ulcer and its Treatment Strategies

Abstract

Background: Diabetes foot ulcers (DFU) are among the most common complications in diabetic patients, leading to amputation and psychological distress. This mini-review covers the general physiology of ulcer healing as well as the pathophysiology of DFU and its therapies. Only a few treatments have been sanctioned and numerous compounds from various pharmacological groups are now being tested at various stages for the prevention and treatment of DFUs. Objective: The main objective of this mini-review is to give concise information on how diabetes mellitus impairs the healing of chronic ulcers by disrupting numerous biological systems of the normal healing process, resulting in diabetic foot ulceration, and the current therapeutic approaches. Method: A review of accessible material from systemic searches in the PubMed/Medline, Scopus, Cochrane Database of Systematic Reviews, published review articles, and Clinical Trials databases (US National Library of Medicine) with no period of limitation was conducted. Result: The treatment of DFUs comprises wound dressings, use of matrix metalloproteinase inhibitors in wound dressing, antibiotics, skin substitutes, pressure off-loading growth factors and stem cells, gene therapy, topical oxygen therapy, etc. Conclusion: The majority of these treatments are aimed at treating diabetic foot ulcers and preventing diabetic wounds from becoming infected. Yet, there is no single therapy that can be advised for diabetic foot ulcer patients. Future treatment strategies should be considered an appropriate treatment option for persistent wounds.

Gender difference as the risk of diabetic foot ulcers in T2DM patients: a meta-analysis

“…Prevention and treatment of DFU is a multidisciplinary process [19]. Understanding the DFU risk factors and taking in-time prevention and treatment measures can improve the patients prognosis [20]. Rismayanti et al [21] show that 5% to 8% DFU patients need amputation which seriously affects their health and life quality.…”

Surgical debridement and maggot debridement therapy can survive patient with diabetic foot ulcer after foot trauma: A case report

“…Additionally, maggot debridement therapy has been shown to be an effective alternative treatment for diabetic foot ulcers, as it involves the use of sterile maggots to eat away dead tissue and bacteria from the wound. This therapy works by secreting enzymes and antimicrobial substances that help to clean the wound and promote healing [ 17 ].…”

Experiencia de la unidad de atención integral al paciente con pie diabético. Hospital Militar Universitario Dr. Carlos Arvelo. Años 2012-2023

“…Los cambios microvasculares pueden provocar una reducción del flujo sanguíneo a la extremidad inferior y retrasar la cicatrización de las heridas. [2][3][4] El pie diabético podría considerarse un verdadero síndrome, si tomamos en cuenta que en su aparición concurren diferentes cuadros patológicos inducidos principalmente por la hiperglucemia crónica.…”