Diagnosis and treatment of diabetic foot ulcer complicated with lower extremity vasculopathy: Consensus recommendation from the Chinese Medical Association (CMA), Chinese Medical Doctor Association (CMDA)

Abstract

Diabetic foot ulcer complicated with lower extremity vasculopathy is highly prevalent, slow healing and have a poor prognosis. The final progression leads to amputation, or may even be life‐threatening, seriously affecting patients' quality of life. The treatment of lower extremity vasculopathy is the focus of clinical practice and is vital to improving the healing process of diabetic foot ulcers. Recently, a number of clinical trials on diabetic foot ulcers with lower extremity vasculopathy have been reported. A joint group of Chinese Medical Association (CMA) and Chinese Medical Doctor Association (CMDA) expert representatives reviewed and reached a consensus on the guidelines for the clinical diagnosis and treatment of this kind of disease. These guidelines are based on evidence from the literature and cover the pathogenesis of diabetic foot ulcers complicated with lower extremity vasculopathy and the application of new treatment approaches. These guidelines have been put forward to guide practitioners on the best approaches for screening, diagnosing and treating diabetic foot ulcers with lower extremity vasculopathy, with the aim of providing optimal, evidence‐based management for medical personnel working with diabetic foot wound repair and treatment.

Efficacy of tibial cortex transverse transport in treating diabetic foot ulcer and its effect on serum omentin-1 and irisin levels

“…Although patients with mild-to-moderate ulcers can achieve clinical outcomes from these therapies, those with severe or recalcitrant ulcers are still confront with minor response to therapy, high complication, and major and minor lower limb amputations [ 6 , 7 ]. A joint group of Chinese Medical Association (CMA) and Chinese Medical Doctor Association (CMDA) expert representatives have reached a consensus that the treatment of lower extremity vasculopathy is the focus of clinical practice to promote the healing process of DFUs [ 8 ].…”

Integrating bioinformatics and multiple machine learning to identify mitophagy-related targets for the diagnosis and treatment of diabetic foot ulcers: evidence from transcriptome analysis and drug docking

“…However, the current clinical diagnosis and treatment of DFU also face challenges, with the clinical diagnosis of DFU being overly dependent on the clinical experience of clinicians and lacking effective treatments ( Armstrong et al, 2017 ; Matos et al, 2018 ; Purwanti et al, 2024 ; Wang F. et al, 2024 ; Wang K. et al, 2024 ). At the present stage, the treatment of DFU patients mainly includes debridement, wound dressing, anti-infection treatment, peripheral vasculopathy treatment, strict glycemic control, and amputation ( McIllhatton et al, 2021 ; Orlando et al, 2021 ; Ahmed et al, 2022 ; Slomski, 2022 ; Jeffcoate et al, 2024 ), but the therapeutic efficacy of these methods is still unsatisfactory and has not yet achieved a satisfactory clinical results, that is, they do not fully control the underlying metabolic lesions ( Bardill et al, 2022 ; Chen et al, 2024 ; Yi et al, 2024 ; Zhang G. et al, 2024 ; Zhang N. et al, 2024 ).…”