1
|
Julien CA, Ha Van G, M'Bemba J, Bourgeon M, Dardari D, Lepeut M, Dumont I, Zemmache MZ, Serrand C, Bouillet B, Sultan A, Schuldiner S. Real-world treatment patterns and diagnosis of charcot foot in franco-belgian diabetic foot expert centers (The EPiChar Study). Acta Diabetol 2023; 60:1209-1218. [PMID: 37184671 DOI: 10.1007/s00592-023-02101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023]
Abstract
AIM To evaluate the real-life diagnosis and therapeutic means of Charcot Neuroosteoarthropathy (CN) in French-Belgian diabetic foot expert centers. METHODS We collected clinical characteristics, results of exams and therapeutic pathways of consecutive adult patients with diabetic osteoarthropathy seen in consultation or hospitalization from January 1 to December 31, 2019 in 31 diabetic foot expert centers. The primary outcome was to describe the diagnostic and management methods for CN according to patient clinical characteristics, the clinical-radiological characteristics of acute and chronic CN and discharge means. RESULTS 467 patients were included: 364 with chronic CN and 103 in the acute phase. 101 patients had bilateral chronic CN. Most patients were male (73.4%), treated with insulin (73.3%), and with multicomplicated diabetes. In the acute phase, edema and increased foot temperature were present in 75% and 58.3% of cases, respectively. Diagnosis confirmation was usually by MRI and the mode of discharge was variable. In the chronic phase, orthopedic shoes were prescribed in 81.5% of cases. CONCLUSIONS This observational study highlights the diagnostic and therapeutic practices in 31 diabetic foot centers. Our results highlight that the use of MRI and the modalities of offloading, an essential treatment in the acute phase, need to be better standardized. Centers were highly encouraging about creating a patient registry.
Collapse
Affiliation(s)
- Carole-Anne Julien
- Service des Maladies métaboliques et Endocriniennes, CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Georges Ha Van
- Service de Diabétologie, AP-HP La Pitié Salpétrière, Paris, France
| | | | - Muriel Bourgeon
- Service Endocrinologie, AP-HP Kremlin Bicêtre, Kremlin Bicêtre, France
| | - Dured Dardari
- Service de Diabétologie, CH Sud Francilien, Corbeil-Essonnes, France
| | - Marc Lepeut
- Service de Diabétologie, CH Roubaix, Roubaix, France
| | | | - Mohammed Zakarya Zemmache
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Chris Serrand
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Benjamin Bouillet
- Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, CHU Dijon, Dijon, France
| | - Ariane Sultan
- 10PhyMedExp, INSERM U1046, UMR 9214, Univ Montpellier, Service Des Maladies Métaboliques, CHU Montpellier, Montpellier, France
| | - Sophie Schuldiner
- VBIC, INSERM U1047, Univ Montpellier, Service Des Maladies Métaboliques Et Endocriniennes, CHU Nîmes, Clinique du Pied Gard Occitanie, Route de Carnon, 30240, Le Grau du Roi, France.
| |
Collapse
|