The diabetic foot management – Recent advance

Abstract

Diabetic ulceration of the foot represents a major global medical, social and economic problem. It is the commonest major end-point of diabetic complications. Diabetic neuropathy and peripheral vascular disease are the main etiological factors in foot ulceration and may act alone, together, or in combination with other factors such as microvascular disease, biomechanical abnormalities, limited joint mobility and increased susceptibility to infection. In the diabetic foot, distal sensory polyneuropathy is seen most commonly. The advent of insulin overcame the acute problems of ketoacidosis and infection, but could not prevent the vascular and neurological complications. Management of diabetic neuropathic ulcer by appropriate and timely removal of callus, control of infection and reduction of weight bearing forces. Management of diabetic ischaemic foot are medical management, surgical management and percutaneous transluminal angioplasty of stenosed and occluded lower extremity arteries. Foot ulceration in persons with diabetes is the most frequent precursor to amputation.

The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial

“…DFU is a major cause of morbidity in diabetic patients, and the mortality rate is about twice that of diabetic patients without foot ulcer (Daousi et al, 2004). Diabetic neuropathy and peripheral vascular disease are the main etiological factors in DFU (Sinwar, 2015). Furthermore, insulin resistance, dyslipidemia, inflammation and oxidative stress play a significant role in the pathogenesis of DFU (Karadurmus et al, 2010;Sytze Van Dam, Cotter, Bravenboer, & Cameron, 2013).…”

Implementation of quality and risk management strategies in wound care trials

“…These wounds are the most common cause of amputation in the diabetic population, and are traditionally treated with off-loading and sharp debridement, however, DFUs are a target for many emerging technologies. 5 Venous leg ulcers are wounds resulting from venous hypertension, which is the result of venous reflux or obstruction. Numerous treatments for these wounds exist, however, the most widely used include some type of debridement in combination with compression dressing.…”

Ulceration risk in diabetic feet: a cross-sectional study

“…A enfermagem, enquanto responsável pela educação para o cuidado, tem papel fundamental na prevenção e detecção precoce das lesões nos pés dos diabéticos. O protocolo atual, indicado pelo Ministério da Saúde, enfoca a importância da avaliação dos membros inferiores das pessoas com diabetes durante a consulta com o enfermeiro como medida de intervenção para evitar o pé diabético (3) . Estudo realizado na região sul do Brasil verificou que a maioria dos diabéticos internados por complicações apresentava baixo conhecimento e atitude negativa em relação ao DM (22) .…”

“…O tratamento é realizado por meio de mudanças comportamentais e no estilo de vida, mas algumas pessoas necessitam de hipoglicemiantes orais e/ou insulina para obter o controle metabólico adequado (1)(2)(3) . O DM2 está associado ao alto risco de desenvolvimento de complicações microvasculares e macrovasculares, bem como de neuropatias (4) .…”