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Diabetic foot care

Stéphanie Chevallier, Simon Le Nabat, Arnaud Druelle, Hugues Lefort, Jean-Éric Blatteau
The hyperbaric chamber is a particularly relevant therapy for the healing of chronic wounds such as radiation-induced wounds, ulcers, diabetic foot or osteomyelitis. This article describes the pathway of a patient with a chronic wound from the perspective of a hyperbaric medicine nurse.
June 2018: Revue de L'infirmière
Kwang Hwan Park, Seung Hwan Han, Joon Pio Hong, Seung-Kyu Han, Doo-Hyung Lee, Bom Soo Kim, Jae Hoon Ahn, Jin Woo Lee
AIMS: This study was conducted to evaluate the efficacy and safety of a novel spray-applied growth factor therapy containing recombinant human epidermal growth factor (rhEGF) for the treatment of chronic diabetic foot ulcers (DFU). METHODS: This study was a phase III double-blind, randomized, placebo-controlled trial. 167 adult patients at six medical centers were randomized to receive routine wound care plus either topical spray treatment with 0.005% rhEGF (n = 82) or an equivalent volume of saline spray (n = 85) twice a day until ulcer healing or for up to 12 weeks...
June 11, 2018: Diabetes Research and Clinical Practice
Irfan Anjum Manarvi, Nader Mahr Matta
BACKGROUND: Studies have shown that newly diagnosed diabetic patients need a lot of information about medical examinations, checkups, tests and precautions for its control besides its disastrous effects on heart, kidneys, eyes, foot and nerves etc. Patients in Saudi Arabia are generally not aware of most of the information they may need which is one the major reasons of its increasing number of patients. Past studies conducted are based on clinical data of hospitals and health care centers only discussed its effects...
June 11, 2018: Current Diabetes Reviews
M Graça Pereira, Susana Pedras, Gabriela Ferreira, José C Machado
This study analyzed the differences over time in newly diagnosed type 2 diabetes patients on reported adherence. A longitudinal design with two assessment moments was used with 268 patients who were assessed on adherence to self-care behaviors and medication, beliefs about medicines, psychological distress, trust in the physician, and satisfaction with care. HbA1c and general beliefs about medicines decreased from T1 to T2 while adherence to foot care, the needs of medicines, and psychological distress increased...
June 1, 2018: Journal of Health Psychology
Kyung Suk Shin, Eun-Hyun Lee
AIM: To examine the relationships of health literacy to diabetes self-care behaviors (diet, physical exercise, foot care and blood glucose monitoring) through empowerment controlling for diabetes education. BACKGROUND: Potential mechanisms of how health literacy links to health outcomes have not clearly elucidated. DESIGN: A cross-sectional study design was used. METHODS: Participants were recruited from three community health centers in South Korea from September 2016 - April 2017 using a convenience sampling method...
June 11, 2018: Journal of Advanced Nursing
Atefeh Ghanbari, Pardis Rahmatpour, Fateme Jafaraghaee, Ehsan Kazemnejad, Malahat Khalili
OBJECTIVE: Nurses play an effective role in diabetic foot care and they should know the best evidence. In this way, implementations according evidence-based clinical practice guidelines have positive effects on nurses' practice and patient outcomes. The objective of this study was quality assessment of diabetic foot ulcer clinical practice guidelines. METHODS: Evidence about nursing care in diabetic foot ulcer in last 5 years was searched and categorized based on nursing diagnosis (ND) and evidence levels and was finally designed as a guideline...
June 7, 2018: Journal of Evidence-based Medicine
P Adiewere, R B Gillis, S Imran Jiwani, A Meal, I Shaw, G G Adams
Background: The World Health Organization (WHO) states that diabetic foot ulcers (DFU) are associated with disability, death among patients with diabetes and substantial costs, if not prevented or managed effectively. The aim here is to examine the effectiveness of patient education in preventing and reducing the incidence or recurrence of adult DFU and amputation. Methods: A systematic review and meta-analysis of randomised clinical trials (RCTs) in adults aged 18+ who have diabetes mellitus (type 1 or type 2) or DFU...
May 2018: Heliyon
Steven L Percival, Matthew Malone, Dieter Mayer, Anne-Marie Salisbury, Gregory Schultz
Infected tissues in the feet of people with diabetes in the form of a diabetic foot ulcer (DFU) present a complex pathology for clinicians to manage. This is partly attributed to the multi-factorial nature of the disease, which may include; altered foot architecture leading to excessive plantar pressures and frictional forces peripheral arterial disease and loss of protective sensation. In addition, to the above co-morbid variables, it is understood that a delayed wound healing state may be perpetuated by the presence of microorganisms residing in the wound tissue...
June 4, 2018: International Wound Journal
Giuseppe Defeudis, Yeganeh Manon Khazrai, Claudia Di Rosa, Chiara Secchi, Anna Montedoro, Anna Rita Maurizi, Andrea Palermo, Paolo Pozzilli, Silvia Manfrini
PURPOSE: The purpose of this study is to evaluate the effectiveness of the educational tool, Conversation Maps™ (CM), combined with a weight loss program, in improving metabolic control of as well as knowledge about diabetes, in a population with type 2 diabetes (T2DM) with mildly impaired glycemic control. METHODS: This is a longitudinal observational study in which 66 subjects, aged 67.8 ± 7.93, were included either in the educational program with CM, once weekly for 4 weeks (T4), combined with a weight loss regime (group A, n = 32), or in standard care with a weight loss regime (group B, n = 34), both followed for 3 months (T3M) after T4...
March 2018: Hormones: International Journal of Endocrinology and Metabolism
Matthew Reaney, Nik Chmiel, Susan Churchill
OBJECTIVES: People with type 2 diabetes (T2DM) should check their feet and protect them against harm, but few do. Living with a spouse contributes to good foot care behaviour. This study explores awareness, perceived susceptibility of, and concern about, foot problems, and reported foot care behaviour, and ways in which a spouse may or may not contribute to foot care in T2DM. METHODS: 1:1 interviews were conducted with 6 individuals with T2DM. Half had a spouse half did not...
June 1, 2018: Psychology & Health
Aleksandra Konarzewska, Anna Korzon-Burakowska, Ludomira Rzepecka-Wejs, Iwona Sudoł-Szopińska, Edyta Szurowska, Michał Studniarek
One of significant challenges faced by diabetologists, surgeons and orthopedists who care for patients with diabetic foot syndrome is early diagnosis and differentiation of bone structure abnormalities typical of these patients, i.e. osteitis and Charcot arthropathy. In addition to clinical examination, the patient's medical history and laboratory tests, imaging plays a significant role. The evaluation usually begins with conventional radiographs. In the case of osteomyelitis, radiography shows osteopenia, lytic lesions, cortical destruction, periosteal reactions as well as, in the chronic phase, osteosclerosis and sequestra...
March 2018: Journal of Ultrasonography
Michael B Strauss, Hojin Moon, Steven La, Anna M Tan, Lientra Quang Lu
OBJECTIVE: This study demonstrates the applicability of an innovative wound score that summates 5 assessments using 2-point (best) to 0-point (worst) grades based on specific findings to generate a 0- to 10-point wound score for categorizing diabetic foot ulcers as well as validates its effectiveness. MATERIALS AND METHODS: Long Beach Wound Scores (LBWS) were determined prospectively over an 18-month period in 105 hospitalized patients, with or without diabetes, with lower extremity wounds...
March 21, 2018: Wounds: a Compendium of Clinical Research and Practice
Jennifer J Hurlow, Gavin J Humphreys, Frank L Bowling, Andrew J McBain
The number of people in the world with diabetes has nearly quadrupled in the past 40 years. Current data show that 25% of these diabetics will develop a foot ulcer in their lifetime and that the cost of care for a diabetic foot ulcer (DFU) is over twice that of any other chronic ulcer aetiology. Microbial biofilm has been linked to both wound chronicity and infection. Close to 1 in 2 diabetics with a DFU are predicted to go on to develop a diabetic foot infection (DFI). The majority of these DFIs have been found to evolve even before the diabetic individual has received an initial referral for expert DFU management...
May 28, 2018: International Wound Journal
Irina Mizeva, Elena Zharkikh, Viktor Dremin, Evgeny Zherebtsov, Irina Makovik, Elena Potapova, Andrey Dunaev
Timely diagnostics of microcirculatory system abnormalities, which are the most severe diabetic complications, is one of the major problems facing modern health care. Functional abnormalities manifest themselves earlier than the structural ones, and therefore their assessment is the issue of primary importance. In this study Laser Doppler flowmetry, a noninvasive technique for the cutaneous blood flow monitoring, was utilized together with local temperature tests and wavelet analysis. The study of the blood flow in the microvascular bed of toes was carried out in the control group of 40 healthy subjects and in two groups of 17 type 1 and 23 type 2 diabetic patients...
May 23, 2018: Microvascular Research
P Y Chen, S Elmer, M Callisaya, K Wills, T M Greenaway, T M Winzenberg
BACKGROUND: People with diabetes have low health literacy, but the role of the latter in diabetic foot disease is unclear. AIM: To determine, through a systematic review and meta-analysis, if health literacy is associated with diabetic foot disease, its risk factors, or foot care. METHODS: We searched PubMed, EMBASE, CINAHL, Web of Science, Scopus and Science Direct. All studies were screened and data extracted by two independent reviewers...
May 26, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Pietro Volpe, Daniela Marcuccio, Giuseppe Stilo, Antonino Alberti, Giovanni Foti, Alberto Volpe, Domenica Princi, Rosangela Surace, Giulia Pucci, Mafalda Massara
The efficacy of umbilical cord blood platelet gel (CBPG) application on healing foot ulcers was analyzed in 10 diabetic patients treated for critical lower limb ischemia by surgical or endovascular arterial revascularization. During a 9-month period, 20 diabetic patients affected by critical lower limb ischemia with tissue loss were enrolled in this nonblinded, consecutive series, randomized clinical trial. After clinical evaluation, patients underwent endovascular or surgical revascularization of the affected limb, followed by minor amputations or surgical debridement of ischemic lesions...
December 2017: Seminars in Vascular Surgery
P A Lazzarini, R E Pacella, D G Armstrong, J J van Netten
Globally ~435 million people have diabetes [1], and an estimated 19-34% (~83-148 million people) of those will be expected to develop foot ulcers in their lifetime [2]. Foot ulcers are typically precipitated by other diabetes-related lower-extremity complications, (DRLECs) including peripheral neuropathy and peripheral vascular disease [2,3]. Collectively, DRLECs are a leading cause of infection, hospitalization and amputation outcomes [2-5], yet, these outcomes are readily preventable with evidence-based care [6,7]...
May 23, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Tzu-Yu Chen, Chia-Huei Lin, Yue-Cune Chang, Chih-Hsin Wang, Yi-Jen Hung, Wen-Chii Tzeng
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) face a higher risk of diabetic foot neuropathy, which increases the risk of death. The early detection of factors that influence diabetic neuropathy reduces the risk of foot lesions, including foot ulcerations, lower extremity amputation, and mortality. PURPOSE: To explore the demographic, disease-characteristic, health-literacy, and foot-self-care-behavior factors that affect diabetic foot neuropathy in patients with T2DM...
June 2018: Hu Li za Zhi the Journal of Nursing
Ilker Uçkay, Benjamin Kressmann, Sébastien Di Tommaso, Marina Portela, Heba Alwan, Hubert Vuagnat, Sophie Maître, Christophe Paoli, Benjamin A Lipsky
Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin-collagen sponge with local care versus local care alone...
2018: SAGE Open Medicine
L Metcalf, M Musgrove, J Bentley, R Berrington, D Bunting, M Mousley, J Thompson, M Sprengel, V Turtle-Savage, F Game, W Jeffcoate
AIMS: To undertake a prospective point prevalence study of the prevalence of active Charcot neuro-inflammatory osteoarthropathy (Charcot disease) in a circumscribed part of England and to audit the time elapsing between disease onset and first diagnosis. METHODS: The prevalence of active Charcot disease of the foot during a single month was assessed by specialist foot care teams at seven secondary care services in the East Midlands region of England. RESULTS: A total of 90 cases were identified, representing 4...
May 21, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
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