Practical guidelines on the management and prevention of the diabetic foot

Apelqvist, Jan; Баккер, К.; Houtum, William H. van; Schaper, Nicolaas C.

doi:10.1002/dmrr.848

Cited by 301 publications

(156 citation statements)

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“…Although there is an 8 year interval between them, both papers by Apelqvist and colleagues [9,14] are very similar. They recommend use of the 10 g Semmes-Weinstein monofilament (SWM), tuning fork and/or cotton wisp for detection of diabetic neuropathy [9,14]. However, to our knowledge, no study has analysed the cotton wisp's diagnostic ability.…”

Section: Foot Ulcer Risk Stratification Systems: Data Synthesismentioning

confidence: 87%

“…The Boyko et al system was the only one externally validated [24,25]. Conversely, the IWGDF was the only group that applied worldwide dissemination techniques (manuals and CD distribution, website creation and others) for the system described in Apelqvist et al articles [9,14].…”

Section: Foot Ulcer Risk Stratification Systems Identifiedmentioning

confidence: 99%

“…At present, numerous stratification systems using different methods have been proposed for this purpose [9,14], but there are few validation studies [15], leading to the problem of how to select the best system for widespread implementation. Our aim was to conduct a systematic review of the existing risk stratification systems for the development of diabetic foot ulcer in order to compare them with regard to selection of variables, development of prediction model, diagnostic accuracy measures, validation and generalisability.…”

Section: Introductionmentioning

confidence: 99%

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Risk stratification systems for diabetic foot ulcers: a systematic review

et al. 2011

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Aims/hypothesis Several risk stratification systems have been proposed for predicting development of diabetic foot ulcer. However, little has been published that assesses their similarities and disparities, diagnostic accuracy and evidence level. Consequently, we conducted a systematic review of the existing stratification systems. Methods We searched the MEDLINE database for studies (published until April 2010) describing the creation and validation of risk stratification systems for prediction of diabetic foot ulcer development. Results We included 13 studies describing or evaluating the following different risk degree stratification systems: University of Texas; International Working Group on Diabetic Foot; Scottish Intercollegiate Guideline Network (SIGN); American Diabetes Association; and Boyko and colleagues. We confirmed that five variables were included in almost all the systems: diabetic neuropathy, peripheral vascular disease, foot deformity, and previous foot ulcer and amputation. The number of variables included ranged from four to eight and the number of risk groups from two to six. Only four studies reported or allowed the calculation of diagnostic accuracy measures. The SIGN system showed some higher diagnostic accuracy values, particularly positive likelihood ratio, while predictive ability was confirmed through external validation only in the system of Boyko et al. Conclusions/interpretation Foot ulcer risk stratification systems are a much needed tool for screening patients with diabetes. The core variables of various systems are very similar, but the number of included variables in each model and risk groups varied greatly. Overall, the quality of evidence for these systems is low, as little validation of their predictive ability has been done.

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Section: Foot Ulcer Risk Stratification Systems: Data Synthesismentioning

confidence: 87%

Section: Foot Ulcer Risk Stratification Systems Identifiedmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk stratification systems for diabetic foot ulcers: a systematic review

et al. 2011

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“…However, symptoms and presentations of DSPN can vary greatly3. It often involves distal small nerve fibers and presents as painful neuropathy, but up to 50% of patients with neuropathy might be asymptomatic – easily resulting in delayed diagnosis, reduced quality of life and increased mortality4, 5.…”

Section: Introductionmentioning

confidence: 99%

Sudoscan is an effective screening method for asymptomatic diabetic neuropathy in Chinese type 2 diabetes mellitus patients

Mao

Liu

Qiao

et al. 2016

J of Diabetes Invest

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Aims/IntroductionThe aim of the present study was to use the sudomotor function test, Sudoscan, as a screening method for the evaluation of asymptomatic diabetic distal symmetric polyneuropathy in Chinese type 2 diabetes patients. As a result, more attention could be paid to those asymptomatic patients who could be easily neglected and underdiagnosed in everyday clinic.Materials and MethodsA total of 394 Chinese type 2 diabetes patients were enrolled and tested for symptoms and clinical signs of neuropathy using the Neurological Symptom Score, Neuropathy Disability Score, and vibration perception threshold. Sudoscan was carried out, and the results were collected as the measurement of the electrochemical skin conductance of both hands and feet.ResultsIn the present study, we found that the abnormal rate of Sudoscan results in patients with asymptomatic neuropathy was higher than those without neuropathy and those with symptomatic neuropathy. This study also showed that lower electrochemical skin conductance at the feet was significantly associated with increasing symptoms, Neurological Symptom Score (r = −0.124, P < 0.05), Neuropathy Disability Score (r = −0.3, P < 0.01) and vibration perception threshold value (r = −0.18, P < 0.05). Logistic analysis showed that age (odds ratio 1.042, 95% confidence interval 1.014−1.071, P < 0.05) and feet electrochemical skin conductance levels (odds ratio 0.98, 95% confidence interval 0.962–0.993, P < 0.01) were independently associated with diabetic distal symmetric polyneuropathy.ConclusionsSudoscan might be a promising tool to screen asymptomatic diabetic distal symmetric polyneuropathy in Chinese patients with type 2 diabetes mellitus.

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“…13 Many centers that adopt such multidisciplinary teams, report reduced rates of amputation. 14,15 We must increase the number of these centers throughout the world in order to provide the best and most comprehensive means of wound-care management.…”

Section: Discussionmentioning

confidence: 99%

Pitfalls of Intralesional Ozone Injection in Diabetic Foot Ulcers: A Case Study

Uzun

Mutluoğlu

Karagöz

et al. 2012

Journal of the American College of Clinical Wound Specialists

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Although the history of ozone therapy dates back to the 19th century, its use has shown a rapid growth of interest in recent decades. Intralesional ozone injection is seldom performed and its safety has not yet been reliably assessed for the treatment of diabetic foot wounds. Herein, we describe a diabetic patient who developed severe foot necrosis and infection after receiving intralesional ozone injections for a non-healing wound.

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Practical guidelines on the management and prevention of the diabetic foot

Cited by 301 publications

References 0 publications

Risk stratification systems for diabetic foot ulcers: a systematic review

Risk stratification systems for diabetic foot ulcers: a systematic review

Sudoscan is an effective screening method for asymptomatic diabetic neuropathy in Chinese type 2 diabetes mellitus patients

Pitfalls of Intralesional Ozone Injection in Diabetic Foot Ulcers: A Case Study

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