Given the high incidence of subsequent diabetic foot complications to the sound foot in patients with a history of proximal LEA and patients being treated for a wound, practice of daily temperature monitoring of a single foot has the potential to significantly improve outcomes and reduce resource utilization in this challenging high-risk population (BMJ)
Diabetes News
Category: Wound Care
Diabetic foot ulcer incidence and survival with improved diabetic foot services: an 18‐year study
Integrated care for the diabetic foot in one National Health Service (NHS) health service area over 18 years was associated with a reduction in first presentations of diabetic foot ulceration, but failed to reduce recurrent ulceration. Cumulative prevalence of all ulcers continues to increase (Diabetic Medicine)
Clinical Commissioning Policy: Hyperbaric oxygen therapy for diabetic lower limb ulceration (diabetic foot ulcer) (all ages)
NHS England has carefully reviewed the evidence to treat diabetic lower limb ulceration with hyperbaric oxygen therapy. We have concluded that there is not enough evidence to make the treatment available at this time.
Remission in diabetic foot infections: Duration of antibiotic therapy and other possible associated factors
Our analysis found no threshold for the optimal duration or route of administration of antibiotic therapy to prevent recurrences of DFI. These limited data might support possibly shorter treatment duration for patients with DFI (Diabetes, Obesity and Metabolism)
Glucagon-like peptide-1 analogue liraglutide facilitates wound healing by activating PI3K/Akt pathway in keratinocytes
Our study suggests that liraglutide may be a potential target drug to improve skin ulcer with diabetes through its specific receptor GLP-1 (Diabetes Research and Clinical Practice)
Markers of Local Inflammation and Bone Resorption in the Acute Diabetic Charcot Foot
We have found an increased A-V flux of IL-6 in the acute diabetic Charcot foot compared to the healthy foot in the same patients (Journal of Diabetes Research)
Efficacy of Low-Level Light Therapy for Treatment of Diabetic Foot Ulcer
LLLT was recognized as a potential method in the comprehensive treatment of DFUs. Further well designed and high-quality studies are required to confirm the role of LLLT in the management of DFUs (Diabetes Research and Clinical Practice)
Skin hydration of the heel with fissure in patients with diabetes: a cross-sectional observational study
To prevent heel fissures, moisturizing care should aim at achieving skin hydration of 20%. If skin hydration is <20%, prevention of fissures may warrant not only specialized moisturizing care but also consideration of treatment for tinea pedis (Chronic Wound Care Management and Research)
Topical Epidermal Growth Factor Spray for the Treatment of Chronic Diabetic Foot Ulcers
This study confirms that application of spray-applied rhEGF in DFU patients results in faster healing velocity and higher complete healing rate regardless of HbA1c levels (Diabetes Research and Clinical Practice)
Diabetes foot care profiles: annual update, 2018
Annual update of indicators in the diabetes foot care profiles (Public Health England)
Barriers to foot care in patients with diabetes as identified by healthcare professionals
The crucial barrier to diabetic foot care is delay in accessing specialist care. Until this is addressed, care will be less than optimum and amputations will continue (Diabetic Medicine)
Current Challenges and Opportunities in the Prevention and Management of Diabetic Foot Ulcers
There is strong suggestive evidence to indicate that appropriate changes in the relevant care pathways can result in a prompt improvement in clinical outcomes (Diabetes Care)
Physical activity and exercise on diabetic foot related outcomes: a systematic review
This review suggests evidence that physical activity and exercise is an effective non-pharmacological intervention to improve diabetic foot related outcomes. Combined multi-disciplinary treatments are more effective in the prevention of foot complications in patients with diabetes (Diabetes Research and Clinical Practice)
Association between biofilm and multi/extensive drug resistance in diabetic foot infection
Multi/extensive drug resistance and previous recurrent DFIs were significantly associated with biofilm formation in patients with diabetic foot (International Journal of Clinical Practice)
Topical antimicrobial agents for treating foot ulcers in people with diabetes
Low-certainty evidence suggests that treatment with antimicrobial dressings may increase the likelihood of healing of these wounds. The limited and weak available evidence does not allow us to draw firm conclusions on the role of any topical antimicrobial in the treatment or prevention of wound infection in people with foot ulcers and diabetes (Cochrane Library)
Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study
Clinical outcomes at 12 months for people with an infected diabetic foot ulcer are generally poor. Our data confirm the adverse prognostic effect of limb ischaemia, longer ulcer duration and the presence of multiple ulcers (Diabetic Medicine)
Diabetic foot
This clinical update is based on recommendations in the standard treatment guideline, The diabetic foot: prevention and management in India 2016, published by the Indian Ministry of Health and Family Welfare (BMJ)
The impact of glycaemic variability on wound healing in the diabetic foot – a retrospective study of new ulcers presenting to a specialist multidisciplinary foot clinic
Our data suggest that there was a significant association between HbA1c variability and healing time in diabetic foot ulcers (Diabetes Research and Clinical Practice)
Diabetes-related major lower limb amputation incidence is strongly related to diabetic foot service provision and improves with enhancement of services: peer review of the South-West of England
Major diabetes-related lower limb amputation incidence is significantly inversely correlated with foot care services provision. Introduction of more effective service provision resulted in significant reductions in major amputation incidence within 2 years. Failure to improve unsatisfactory service provision resulted in continued high amputation incidence (Diabetic Medicine)
Unplanned 30-day readmission in patients with diabetic foot wounds treated in a multidisciplinary setting
We found a 17% unplanned 30-day readmission rate in this prospective cohort of DFU patients enrolled in a multidisciplinary diabetic foot service. Only current smoking and hypertension were independent predictors of readmission after risk adjustment (Journal of Vascular Surgery)
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