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Li X, Xiao X, Zhang Y, Long R, Kankala RK, Wang S, Liu Y. Microneedles based on hyaluronic acid-polyvinyl alcohol with antibacterial, anti-inflammatory, and antioxidant effects promote diabetic wound healing. Int J Biol Macromol 2024; 282:137185. [PMID: 39489235 DOI: 10.1016/j.ijbiomac.2024.137185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 10/19/2024] [Accepted: 10/31/2024] [Indexed: 11/05/2024]
Abstract
Diabetic wound healing has become one of the major clinical burdens due to uncontrolled bacterial growth and an increase in the risk of various microbial infections. Despite excellent antioxidant properties, the poor aqueous solubility of resveratrol (RES) hampers its applicability. In this study, we proposed a novel multifunctional microneedle patch loaded with RES-encapsulated polymeric micelles. Resveratrol micelles (RES MC) were loaded in the microneedle tip, while the base part was coated with the antibiotic gentamicin (GEN) to promote wound healing. The microneedle tip composed of sodium hyaluronate (HA) could effectively deliver the anti-inflammatory and antioxidant RES MC. Furthermore, the base of the microneedle patch composed of polyvinyl alcohol (PVA) offered excellent flexibility, releasing GEN and providing resistance to bacterial contamination, thereby further promoting wound repair. In vitro antibacterial experiments indicated that the bactericidal rate reached 99 %. Further, the wound healing rate was recorded as 86.05 % on the 11th day of diabetes wound treatment. Together, the multifunctional microneedle patch with excellent biocompatibility exhibited anti-inflammatory, antioxidant, and antibacterial effects on the wound healing process, potentiating its efficacy in the treatment of diabetic wounds.
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Affiliation(s)
- Xuemei Li
- College of Chemical Engineering, Huaqiao University, Xiamen 361021, China
| | - Xi Xiao
- College of Chemical Engineering, Huaqiao University, Xiamen 361021, China
| | - Yiheng Zhang
- College of Chemical Engineering, Huaqiao University, Xiamen 361021, China
| | - Ruimin Long
- College of Chemical Engineering, Huaqiao University, Xiamen 361021, China
| | | | - Shibin Wang
- College of Materials Science and Engineering, Huaqiao University, Xiamen 361021, China; Institute of Pharmaceutical Engineering, Huaqiao University, Xiamen 361021, China; Fujian Provincial Key Laboratory of Biochemical Technology, Xiamen 361021, China
| | - Yuangang Liu
- College of Chemical Engineering, Huaqiao University, Xiamen 361021, China; Institute of Pharmaceutical Engineering, Huaqiao University, Xiamen 361021, China; Fujian Provincial Key Laboratory of Biochemical Technology, Xiamen 361021, China.
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Nekouei M, Tehrani FJ, Vasli P, Nasiri M. The effect of seven-step educational strategy on knowledge of diabetic foot ulcer prevention, critical thinking and self-efficacy of nursing students: A randomized controlled trial. NURSE EDUCATION TODAY 2024; 137:106164. [PMID: 38503249 DOI: 10.1016/j.nedt.2024.106164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Diabetic foot ulcer is a significant complication of diabetes that carries a high mortality risk and is associated with substantial financial costs. Choosing a suitable educational model for nursing students as future nurses is necessary to improve knowledge and manage issues related to caring for diabetic patients. OBJECTIVES To determine the effect of education based on the 7E learning cycle model on the knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy in nursing students. DESIGN A single-blind, randomized controlled trial with a parallel group. SETTINGS This study was conducted in a nursing school and hospitals covered by it in Iran. PARTICIPANTS 98 students studying in the fourth semester of the Bachelor of Nursing course. METHODS Students were divided into two distinct groups at random: an experimental group (class A, with 51 participants), and a control group (class B, with 47 participants). The participants of the experimental group were provided with an education based on the 7E learning cycle model, while the control group received conventional teaching method. Data collection methods included pre- and post-tests using research instruments (demographic questionnaire, Kaya Diabetic Foot Prevention Knowledge Questionnaire, Ricketts' Critical Thinking Disposition Questionnaire, and General Self-Efficacy Scale). The data were analyzed using descriptive statistics, non-parametric Mann-Whitney and Wilcoxon tests, parametric independent sample t-tests, ANCOVA, and paired sample t-tests. RESULTS The difference in mean scores of diabetic foot ulcer prevention knowledge (Z = -6.232, p < 0.001), critical thinking (t (50) = -4.382, p < 0.001), and self-efficacy (Z = -4.427, p < 0.001) in the experimental group were statistically significant between the time interval before the intervention and one month after its completion. CONCLUSIONS Compared to conventional method of teaching, education based on the 7E learning cycle model is a more effective method to improve nursing students' knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy.
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Affiliation(s)
- Mehrad Nekouei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereshteh Javaheri Tehrani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Shen Q, Li B, Chen H, Gao S, Hu Y, Sun Y, Li G. Podiatrist intervention could reduce the incidence of foot ulcers in patients with diabetes: a hospital survey in China. J Wound Care 2024; 33:S25-S32. [PMID: 38573950 DOI: 10.12968/jowc.2024.33.sup4.s25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of podiatrists in preventing diabetic foot ulcers (DFUs) in China. METHOD The study was a prospective investigation. A total of 300 patients were enrolled from May 2016 to May 2018 in Handan Central Hospital, China. All patients who participated in this study had been diagnosed with type 2 diabetes, according to the International Classification of Diseases (ICD-10). All participants underwent our survey, which included basic patient data and information about DFUs. The patients were followed for one year, during which time they received appropriate intervention from podiatrists, including lifestyle guidance, callus resection, tinea grinding and ingrown nail correction. At the end of the year all the patients were surveyed again. The data before and after the year were statistically compared. RESULTS The results showed that the incidence of DFUs in patients with diabetes was significantly decreased after one year of intervention from podiatrists (20.7% versus 6.7%, p<0.001). Additionally, there was a negative correlation between the number of intervention visits and the number of DFU occurrences (Spearman correlation coefficient: -0.496, p<0.001). Furthermore, we found that 68 patients with a history of DFUs or amputation had an obviously reduced incidence of DFUs after intervention by a podiatrist (89.7% versus 27.9%, p<0.001). We also investigated other foot risk factors in all participants, such as limb neuropathy (76.3%), lower extremity vascular disease (65.7%) and foot paralysis (43.7%). CONCLUSION The results of this study help in understanding the situation of patients with diabetes in China and to prove that standardised podiatrist intervention has an important role in inhibiting the occurrence and development of DFUs.
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Affiliation(s)
- Qian Shen
- School of Foreign Studies of Zhongnan University of Economics and Law; Wuhan, China
| | - Binghui Li
- Department of Wound Repair Surgery, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huating Chen
- Department of Wound Repair Surgery, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suwen Gao
- Department of Endocrinology, Handan Central Hospital, Handan, China
| | - Yingyue Hu
- Department of Wound Repair Surgery, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Sun
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gongchi Li
- Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Wang C, Li T, Guo R, Ji Q, Wang J, Cao Y. [Research on the method of loading exosomes onto absorbable stents]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2024; 38:206-210. [PMID: 38385234 PMCID: PMC10882228 DOI: 10.7507/1002-1892.202310068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Objective To explore a method of loading exosomes onto absorbable stents. Methods By building a stent-(3-aminopropyl) triethoxysilane-1, 2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy (polyethylene glycol) 5000]-exosomes connection, the exosomes were loaded onto absorbable stents to obtained the exosome-eluting absorbable stents. The surface conditions of the stents and absorption of exosomes were observed by scanning electron microscope and identified through the time-of-flight mass spectrometry; the roughness of the stents' surfaces was observed by atomic force microscope; the appearances and sizes of the stents were observed by stereomicroscope; and the radial force was tested by tensile test machine. The absorbable stents were used as control. Results The scanning electron microscope observation showed that the exosome-eluting absorbable stents had some small irregular cracks on the surface where many exosomes could be seen. The atomic force microscopy observation showed that within the range of 5 μm 2, the surface roughness of the absorbable stents was ±20 nm, while the surface roughness of the exosome-eluting absorbable stents was ±70 nm. In the results of time-of-flight mass spectrometry, both the exosome-eluting absorbable stents and exosomes had a peak at the mass charge ratio of 81 (m/z 81), while the absorbable stents did not have this peak. The peak of exosome-eluting absorbable stents at m/z 73 showed a significant decrease compared to the absorbable stents. The stereomicroscope observation showed that the sizes of exosome-eluting absorbable stents met standards and the surfaces had no cracks, burrs, or depressions. The radial force results of the exosome-eluting absorbable stents met the strength standards of the original absorbable stent. Conclusion By applying the chemical connection method, the exosomes successfully loaded onto the absorbable stents. And the sizes and radial forces of this exosome-eluting absorbable stents meet the standards of the original absorbable stents.
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Affiliation(s)
- Chenchen Wang
- Jiamusi University, Jiamusi Heilongjiang, 154007, P. R. China
| | | | | | - Qinghui Ji
- Jiamusi University, Jiamusi Heilongjiang, 154007, P. R. China
| | - Jiangning Wang
- Department of Orthopedics, Shijitan Hospital Affiliated to Capital Medical University, Beijing, 100038, P. R. China
| | - Yulin Cao
- Tangyi Holdings (Shenzhen) Co., Ltd, Shenzhen Guangdong, 518000, P. R. China
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Letta S, Goshu AT, Sertsu A, Nigussie K, Negash A, Yadeta TA, Bulti FA, Geda B, Dessie Y. Diabetes knowledge and foot care practices among type 2 diabetes patients attending the chronic ambulatory care unit of a public health hospital in eastern Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e070023. [PMID: 38016795 PMCID: PMC10685947 DOI: 10.1136/bmjopen-2022-070023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 10/31/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE To assess diabetes knowledge and foot care practices among type 2 diabetes patients. DESIGN An institution-based cross-sectional study was undertaken from 1 January to 31 January 2021. SETTING Eastern Ethiopia. PARTICIPANTS Randomly selected type 2 diabetes patients who were available during the data collection period were included. OUTCOMES Patients' diabetes knowledge was assessed with the revised diabetes knowledge test questionnaire. Five items were used to evaluate foot self-care practices. RESULTS The study population comprised of 549 patients. About 52.5% of the patients had adequate diabetes knowledge (95% CI: 48.2% to 56.7%). Patients with an educational level of secondary school and above (adjusted OR (AOR): 2.04, 95% CI: 1.13 to 3.71), (AOR: 5.28, 95% CI: 2.28 to 12.22), and those with medium and above wealth status (AOR: 3.81, 95% CI: 2.24 to 6.47), (AOR: 3.46, 95% CI: 1.98 to 6.04), were found to have better odds of having adequate diabetes knowledge. However, those aged >55 years (AOR: 0.47, 95% CI: 0.22 to 0.99) were found to have lower odds of adequate diabetes knowledge.Of the total included patients, 20.2% (95% CI: 16.9% to 23.8%) had good foot care practices. Knowledge of the target fasting plasma glucose (AOR: 3.18, 95% CI: 1.94 to 5.22) and adequate diabetes knowledge (AOR: 3.40, 95% CI: 1.95 to 5.91) were significantly associated with good foot care practices. CONCLUSION According to this study, about half of individuals with type 2 diabetes have adequate levels of knowledge about the disease. In addition, only one out of every five patients has good foot care habits. Diabetes education should emphasise the significance of rigorous adherence to daily foot care practices.
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Affiliation(s)
- Shiferaw Letta
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Abel Tibebu Goshu
- School of Nursing and Midwifery, Asrat Weldeyes Health Science College, Debre Berhan University, Debre Berhan, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Kabtamu Nigussie
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Fekadu Aga Bulti
- School of Nursing and Midwifery, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Biftu Geda
- College of Health Sciences, Department of Nursing, Madda Walabu University, Shashamene, Ethiopia
| | - Yadeta Dessie
- School of Public Health, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
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Viadé J, Nicolás M, Bundó M, Sirvent M, Riera C, Sabriá M. A novel assessment, diagnostic and treatment system for diabetic foot. J Foot Ankle Res 2023; 16:84. [PMID: 38001471 PMCID: PMC10675945 DOI: 10.1186/s13047-023-00687-z] [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: 08/12/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND This report aims to present a novel system for the management of foot lesions in patients with diabetes. It was developed in the diabetic foot unit (DFU) of the Mutua de Terrassa University Hospital (HUMT) by primary care professionals, the Diabetic Foot Clinic (DFC), and during emergency cases treated by our group based on daily activities in patients with neuropathy or neuroischemia. BODY: This system considers five degrees of action based on two fixed variables: presence of infection and lesion depth. These two variables allowed the user to investigate aspects of the system until the overall action required by the pathology is made clear. These variables establish pathology stages of various severities that require different actions in aspects of care, management and treatment. CONCLUSION This tool facilitates diagnosis, treatment, and coordination among different members of a multidisciplinary team working in specialized hospital units, primary care centers, and emergency settings.
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Affiliation(s)
- Jordi Viadé
- Department of Endocrinology & Nutrition, Hospital Germans Trias I Pujol, Autonomous University of Barcelona, Badalona, Spain
| | - Maria Nicolás
- Private Practice Diabetic Foot Clinic, Autonomous University of Barcelona, Sabadell, Barcelona, Spain.
| | - Magdalena Bundó
- Primary Health Care Center Ronda Prim, Gerència d'Àmbit d'Atenció Primària Metropolitana Nord de Barcelona, Institut Català de La Salut, Mataró, Spain
| | - Marc Sirvent
- Department General, University Hospital of Granollers, CIBERCV, ISCIII, Granollers, Spain
| | - Clàudia Riera
- Department of Angiology and Vascular Surgery, University Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - Miquel Sabriá
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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Wang H, Luo W, Ye Y, Li N, Li X, Fu X, Yu L, Hu T, Dai W, Zhou Q. Knowledge, attitudes, and practice of Endocrinology healthcare workers regarding screening for pre-ulcerative diabetic foot lesions. J Tissue Viability 2023; 32:472-479. [PMID: 37558559 DOI: 10.1016/j.jtv.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/07/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To investigate knowledge, attitude and practice of screening pre-ulcerative lesions among endocrinology healthcare workers. METHODS A new questionnaire was developed and distributed online and 1004 valid questionnaires were returned. T-test, ANOVA, Pearson correlation analysis, and multiple linear regression were used for statistical analysis. RESULTS A total of 1100 questionnaires were returned, and 96 were excluded. The scores of endocrinology healthcare workers' knowledge, attitude, and practice for screening for pre-ulcerative lesions were 45.46 ± 16.26, 92.11 ± 10.50, and 72.27 ± 17.63 respectively. 60.2% participants had been trained to screen for pre-ulcerative lesions, but 39.8% had not been trained. 31.8% of healthcare professionals claimed that their hospital did not have a screening project for pre-ulcer diabetic foot lesions. Positive relationships were found between knowledge and practice and between attitude and practice. Multiple linear regression analysis showed that: level II hospital and tertiary hospital were the main factors influencing the knowledge scores; Undergraduate and participating in relevant training were the main factors influencing the attitude scores; participating in relevant training, hospital conducts relevant projects, and patient cooperation, and working hours were the main factors influencing the practice score. CONCLUSIONS Endocrinology healthcare workers need more knowledge regarding pre-ulcerative lesions, and their screening practices need to be strengthened. Increased education and training for pre-ulcerative lesion screening should be implemented among healthcare workers in endocrinology departments.
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Affiliation(s)
- Honglin Wang
- Xiangya Nursing School of Central South University, Changsha, 410013, China
| | - Wenjing Luo
- Abdominal Oncology Ward, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Ying Ye
- Xiangya Nursing School of Central South University, Changsha, 410013, China
| | - Na Li
- Xiangya Nursing School of Central South University, Changsha, 410013, China
| | - Xinyi Li
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Operating Room, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Xiaoai Fu
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Ling Yu
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Ting Hu
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Weiwei Dai
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Wound Center, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Qiuhong Zhou
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Diabetic Foot Prevention and Treatment Center, Xiangya Hospital, Central South University, Changsha, 410008, China.
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Sun B, Chen Y, Man Y, Fu Y, Lin J, Chen Z. Clinical value of neutrophil-to-lymphocyte ratio and prognostic nutritional index on prediction of occurrence and development of diabetic foot-induced sepsis. Front Public Health 2023; 11:1181880. [PMID: 38026334 PMCID: PMC10630165 DOI: 10.3389/fpubh.2023.1181880] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background Diabetic foot-induced sepsis is a serious complication associated with increased disability and mortality in hospitalized patients. Early prediction of admission and detection effectively improve treatment options and prevent further deterioration. This study aims to evaluate the clinical value of the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI) to predict the risk of sepsis in patients with diabetic foot ulcers (DFU). Methods Retrospective analysis was performed on 216 patients who were admitted to the Fujian Medical University Union Hospital between January 2015 and December 2022. Patients with DFU were divided into the non-sepsis (n = 166) and the DFU-induced sepsis (n = 50) groups. The independent factors of DFU-induced sepsis were determined by univariate and multivariate logistic regression analyses. A receiver operating characteristic (ROC) curve was performed to compare the area under the curves (AUC) of PNI and NLR. Results Multivariate logistic regression analysis revealed that the PNI, NLR, international normalized ratio (INR), thrombin time (PT), and C-reactive protein (CRP) were independent prognostic factors for DFU-induced sepsis. After adjusting for potential confounders, the adjusted odds ratios of NLR for DFU-induced sepsis were 1.121 (1.072-1.172), 1.132 (1.077-1.189), and 1.080 (1.022-1.142), while those of PNI were 0.912 (0.873-0.953), 0.902 (0.856-0.950), and 1.004 (1.001-1.006). Moreover, the AUC of NLR was significantly greater than that of CRP (0.790, 95% CI: 0.689-0.891, p < 0.001 vs. 0.780, 95% CI: 0.686-0.873, p < 0.001). Conclusion NLR and PNI have been regarded as readily and independently predictive markers in patients with DFU-induced sepsis. NLR is critical for the early detection and effective treatment of DFU-induced sepsis and is superior to CRP.
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Affiliation(s)
- Bing Sun
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yimin Chen
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yulin Man
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yu Fu
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jianchang Lin
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhaohong Chen
- Burn & Wound Repair Department, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Burn Medical Center, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Provincial Key Laboratory of Burn and Trauma, Fujian Medical University Union Hospital, Fuzhou, China
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Xu Y, Fu X, Chen F. Epalrestat is effective in treating diabetic foot infection and can lower serum inflammatory factors in patients. Am J Transl Res 2023; 15:6208-6216. [PMID: 37969201 PMCID: PMC10641352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/27/2023] [Indexed: 11/17/2023]
Abstract
This study was designed to determine the efficacy of epalrestat on patients with diabetic foot infection (DFI) and its effects on serum inflammatory factors in the patients. METHODS The data of 80 patients with DFI treated in the First Affiliated Hospital of Jiangxi Medical College from May 2020 to May 2022 were analyzed retrospectively. Among them, patients who received routine comprehensive treatment were enrolled into the control group (n=37), and those who received epalrestat on the basis of routine comprehensive treatment were enrolled into the study group (n=43). The changes of serum inflammatory factors before and after treatment, granulation tissue grading and efficacy in the two groups were analyzed and compared, and the wound healing time, hospitalization time and adverse reactions (including nausea and vomiting, dizziness, headache, pruritus, etc.) of the two groups were statistically analyzed. The prognosis of the patients within 1 year after treatment was analyzed, and the independent risk factors of poor prognosis were analyzed through logistic regression. RESULTS Before treatment, the two groups were not significantly different in the levels of tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6), while after treatment, the levels decreased significantly in both groups, with significantly lower levels in the study group than those in the control group. The study group had a significant lower proportion of patients with grade 0/grade 1 granulation tissue than the control group, and had a significantly higher proportion of patients with grade 2/grade 4 granulation tissue than the control group, but the proportion of patients with grade 3 granulation tissue in the two groups was not greatly different. The study group experienced notably shorter wound healing time and hospitalization time than the control group. A notably higher overall response rate was found in the study group than that in the control group. In addition, the total incidence of adverse reactions was not greatly different between the two groups. BMI, diabetes mellitus type, Wagner grading and classification of diabetic foot infection were found to be the risk factors affecting the prognosis of patients, and Wagner grading was an independent risk factor affecting the prognosis of patients. CONCLUSION Epalrestat is effective in treating DFI, because it can lower the levels of serum inflammatory factors, shorten the time of wound healing and hospitalization, and promote the growth and recovery of granulation, without increasing adverse reactions. Therefore, it is worthy of clinical promotion.
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Affiliation(s)
- Yan Xu
- Department of Internal Medicine, Jiangxi Medical CollegeShangrao, Jiangxi, China
- Department of General Internal Medicine, The First Affiliated Hospital of Jiangxi Medical CollegeShangrao, Jiangxi, China
| | - Xiaohu Fu
- Department of Endocrinology, Shangrao Municiple HospitalShangrao, Jiangxi, China
| | - Fuying Chen
- Department of Internal Medicine, Jiangxi Medical CollegeShangrao, Jiangxi, China
- Department of Gastroenterology, The First Affiliated Hospital of Jiangxi Medical CollegeShangrao, Jiangxi, China
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T R, R MM, Kumar N, Hegde K, Unnikrishnan B, Mithra P, Holla R, Suma B, Rao AM, Nikitha P, Sahama M AR. Obstacles for self-management practices among diabetes patients: A facility-based study from Coastal South India. F1000Res 2023; 12:839. [PMID: 40115411 PMCID: PMC11923534 DOI: 10.12688/f1000research.138146.1] [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] [Accepted: 06/30/2023] [Indexed: 03/23/2025] Open
Abstract
Background The purpose of the study was to assess the obstacles faced by diabetes patients in their self-care and determine the factors associated with these obstacles. The management of diabetes mellitus (DM) extends beyond the clinician's efforts, with the responsibility of the care also being shared by the patient to achieve better treatment outcomes and prevent complications. Self-care management is the most important part of DM treatment, which includes diet, regular exercise, blood glucose monitoring, medication and foot care. Methods A facility-based cross-sectional study was conducted among 107 type 2 DM patients aged >18 years using the Diabetes Obstacles Questionnaire-30. Patients scoring a mean response score >3 were considered to have an obstacle. We included age, gender, socioeconomic status (SES), duration of DM and blood glucose levels as factors for regression analysis and a P value <0.05 was considered to be statistically significant. Results A large majority (64.5%, n = 69) of our participants were aged above 55 years and belonged to lower socio-economic status (65.4%, n = 70). Family history of DM was present in 41% (n=44) of the participants. The median duration of DM among the participant was 10 (4 - 7) years. In our study, the participants faced obstacles for two items in the domains: Support from Friends & Family (mean score: 3.73) and Knowledge of the Disease (mean score: 3.58). A multinominal regression analysis revealed SES was predictive of participants who could not understand information from literature with a P. value of 0.002 (OR: 3.65, CI: 1.60-8.338). Conclusion The two major obstacles to self-management practices that were identified were in the domains of Support from Friends and Family, and Knowledge of the Disease. Socioeconomic status was identified to be a predictive factor associated with the participants who are not able to understand information from the literature.
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Affiliation(s)
- Rekha T
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Murali Mohan R
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Kausthubh Hegde
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Bhaskaran Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ramesh Holla
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Balanarayana Suma
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Aadithya M Rao
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Patil Nikitha
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Aysha Roushida Sahama M
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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B. G. S, V. U, Shivaram JM, Belehalli P, M. A. S, H. C. C, Sikkandar MY, Brioschi ML. Diabetic Foot Assessment and Care: Barriers and Facilitators in a Cross-Sectional Study in Bangalore, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5929. [PMID: 37297533 PMCID: PMC10252617 DOI: 10.3390/ijerph20115929] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
(1) Background: This cross-sectional study aims to highlight the assessment and foot care practices in an advanced clinical setting, the clinical characteristics of the patients, and to understand the barriers and facilitators for effective foot care from the perspectives of healthcare practices, resources, and patients' socioeconomic and cultural practices, and other aspects in terms of new technologies for effective foot care such as infrared thermography. (2) Methods: Clinical test data from 158 diabetic patients and a questionnaire to assess the foot care education retention rate were collected at the Karnataka Institute of Endocrinology and Research (KIER) facility. (3) Results: Diabetic foot ulcers (DFUs) were found in 6% of the examined individuals. Male patients were more likely to have diabetes complications, with an odds ratio (OR) of 1.18 (CI = 0.49-2.84). Other diabetes problems raised the likelihood of DFUs by OR 5 (CI = 1.40-17.77). The constraints include socioeconomic position, employment conditions, religious customs, time and cost, and medication non-adherence. The attitude of podiatrists and nurses, diabetic foot education, and awareness protocols and amenities at the facility were all facilitators. (4) Conclusions: Most diabetic foot complications might be avoided with foot care education, regular foot assessments as the standard of treatment, and self-care as a preventive/therapeutic strategy.
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Affiliation(s)
- Sudha B. G.
- Department of Computer Science and Engineering, B.M.S. College of Engineering, Bangalore 560019, India
| | - Umadevi V.
- Department of Computer Science and Engineering, B.M.S. College of Engineering, Bangalore 560019, India
| | - Joshi Manisha Shivaram
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore 560019, India
| | - Pavan Belehalli
- Department of Podiatry, Karnataka Institute of Endocrinology and Research, Bangalore 560019, India
| | - Shekar M. A.
- Department of Podiatry, Karnataka Institute of Endocrinology and Research, Bangalore 560019, India
| | - Chaluvanarayana H. C.
- Department of Podiatry, Karnataka Institute of Endocrinology and Research, Bangalore 560019, India
| | - Mohamed Yacin Sikkandar
- Medical Equipment Technology, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Marcos Leal Brioschi
- Medical Thermography Service, Neurology Department, Hospital das Clínicas, Sao Paulo University, Sao Paulo 01246-903, Brazil
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12
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Bonilla-Carrasco MI, Rasero-Fernández E, Aguayo-González M, Rafael-Gutiérrez SS. "Self-care of the feet in people with type 2 diabetes. A qualitative study". ENFERMERIA CLINICA (ENGLISH EDITION) 2023:S2445-1479(23)00021-8. [PMID: 37060942 DOI: 10.1016/j.enfcle.2023.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 01/25/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVE To understand the experiences of adults over 65 years of age with type 2 diabetes mellitus, regarding foot self-care. METHOD Qualitative phenomenological study with a descriptive approach. It is carried out in the facilities of the Primary Care Center of Les Planes de Sant Joan Despí, Barcelona, belonging to the Catalan Institute of Health. For the data collection, a semi-structured and individual interview was used, with a script of basic aspects to be explored, not closed and focused on the objectives of the research. The interviews were carried out between June 2019 and December 2020. A thematic analysis was carried out concomitantly with the collection of these. RESULTS A final sample of 13 persons (4 men and 9 women) participated in the study. Adherence to diabetic foot self-care recommendations is irregular. Participants explain risky behaviours despite knowing that they can cause injury to feet previously considered high risk. The evaluation of the podiatrist supposes an economic cost that some people cannot afford. CONCLUSIONS The nurse has to do an exhaustive follow-up of how persons with diabetes take care of her feet, insisting on preventive recommendations not only in the annual review but every time the person attends the diabetes follow-up consultation. Effective nurse-podiatrist communication is needed to improve prevention and follow-up of people at risk of diabetic foot disease.
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Affiliation(s)
- María Isabel Bonilla-Carrasco
- Enfermera Asistencial CAP Les Planes, Sant Joan Despí. Profesora asociada del Departamento de Enfermería de la Facultad de Medicina de la Universidad Autónoma de Barcelona (UAB). Bellaterra. Spain.
| | - Elisabeth Rasero-Fernández
- Enfermera Asistencial CAP Les Planes, Sant Joan Despí. Profesora asociada del departamento de Enfermería de la Universidad de Barcelona (UB), Spain
| | - Mariela Aguayo-González
- Profesora asociada del Departamento de Enfermería de la Facultad de Medicina de la Universidad Autónoma de Barcelona (UAB). Bellaterra, Spain
| | - Sabiniana San Rafael-Gutiérrez
- Profesora colaboradora permanente del Departamento de Enfermería de la Facultad de Medicina de la Universidad Autónoma de Barcelona (UAB). Bellaterra, Spain
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13
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Swain J, Sahoo AK, Jadhao PA, Sravya S, Teli BR. Addressing the Inertia: A Holistic Approach to Diabetic Foot Evaluation. Cureus 2023; 15:e37186. [PMID: 37168198 PMCID: PMC10166298 DOI: 10.7759/cureus.37186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
Diabetic foot is a well-known complication with considerable morbidity and mortality related to the diabetic population. Neuropathy, deformity, infection and ischemia are important contributors to the pathogenesis of diabetic foot ulcers. A multidisciplinary team approach by physicians, nursing staff, diabetic educators and the caregiver as well as close monitoring of feet by the patient himself can prevent foot-related complications. Proper foot care, foot hygiene, annual foot examination and the correct choice of footwear are the main elements in preventing foot problems like deformity, ulceration and amputations. Physicians play a key role in the early detection and prevention of foot problems. Foot evaluation is the most neglected part of physical examination in diabetic patients. This inertia is evident in both physicians and patients. Emphasis on visual inspection and physical foot examination at every visit may address the morbidity and mortality due to diabetic neuropathy and vasculopathy. This article will highlight extensively history taking and foot examination in the diabetic foot clinic. Optimal glycemic control, simple foot care practices, knowledge and appropriate footwear use play an important role to reduce the disease burden.
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AlZubaidi HAA, Alfaqih ANO, Alothayqi MHA, Alfaqih HMH, Albarakati AJA, Taha M, Alnashri AM. Knowledge and Practice of the Preventive and Care Methods for Diabetic Foot Among the Caregivers of Diabetic Patients in Saudi Arabia. Cureus 2023; 15:e37887. [PMID: 37213954 PMCID: PMC10199721 DOI: 10.7759/cureus.37887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023] Open
Abstract
Background Diabetic foot syndrome is a complex and multifactorial disease process involving neuropathy, peripheral arterial disease, osteomyelitis, diabetic foot ulcer (DFU), and amputation. DFUs are a common and burdensome manifestation of the syndrome, responsible for diabetes-related morbidity and mortality. Successful management of DFU requires collaboration between patients and caregivers. This study assesses the knowledge, experience, and practices of the caregivers of diabetic foot patients in Saudi Arabia, highlighting the need for targeted interventions to improve knowledge and practices in certain subgroups of caregivers. Method The primary objective of this study was to evaluate the proficiency and practicality of caregivers who provide care to patients with diabetic foot in the Kingdom of Saudi Arabia. To accomplish this, a cross-sectional study was conducted among caregivers of diabetic foot patients who were aged 18 years or older and living in Saudi Arabia. The participants were randomly chosen to ensure that the sample was representative. The data collection process involved the distribution of a structured online questionnaire via various social media platforms. Prior to the distribution of the questionnaire, the participants were informed about the study's objectives, and their informed consent was obtained. Additionally, adequate measures were taken to ensure the confidentiality of the participants and their caregiving status. Results Among the initial pool of 2990 participants, 1023 individuals were excluded from the study due to their status as non-caregivers of diabetic patients or being under the age of 18 years. Consequently, the final sample size consisted of 1921 caregivers. The majority of the participants were female (61.6%), married (58.6%), and had a bachelor's degree (52.4%). The findings revealed that 34.6% of caregivers were attending to patients with diabetic foot, of which 8.5% reported poor foot status and 9.1% reported amputation. Caregivers reported examining the patient's feet in 75.2% of cases, and the feet were cleaned and moisturized by either the patient or caregiver. Nails were trimmed by 77.8% of caregivers, and 49.8% of them did not permit patients to walk barefoot. Moreover, knowledge of diabetic foot care was positively correlated with being female, having a post-graduate degree, having personal experience with diabetes, caring for a patient with diabetic foot, and having prior experience in treating diabetic foot. Conversely, lower knowledge levels were associated with divorced or unemployed caregivers and those residing in the northern region. Conclusion The present study highlights that caregivers of diabetic foot patients in Saudi Arabia possess a satisfactory level of knowledge and follow appropriate practices regarding foot care. Nonetheless, it is imperative to identify specific subgroups of caregivers who may require additional education and training to improve their knowledge and practices concerning diabetic foot care. The results of this study could potentially inform the design of tailored interventions aimed at reducing the significant burden of morbidity and mortality attributed to diabetic foot syndrome in the Saudi Arabian context.
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Affiliation(s)
- Hassan Ali A AlZubaidi
- Department of Medicine and Surgery, Umm AlQura University, Al-Qunfudah College of Medicine, Al-Qunfudhah, SAU
| | - Ali Nori O Alfaqih
- Department of Medicine and Surgery, Umm AlQura University, Al-Qunfudah College of Medicine, Al-Qunfudhah, SAU
| | | | - Hassan Mohammed H Alfaqih
- Department of Medicine and Surgery, Umm AlQura University, Al-Qunfudah College of Medicine, Al-Qunfudhah, SAU
| | - Alaa Jameel A Albarakati
- Department of Surgery, Umm AlQura University, Al-Qunfudah College of Medicine, Al-Qunfudhah, SAU
| | - Medhat Taha
- Department of Anatomy, Umm AlQura University, Al-Qunfudah College of Medicine, Al-Qunfudhah, SAU
- Department of Anatomy and Embryology, Mansoura University, Mansoura, EGY
| | - Abdulkarim M Alnashri
- Department of Medicine and Surgery, Umm AlQura University, Al-Qunfudah College of Medicine, Al-Qunfudhah, SAU
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Constantin C, ", Georgescu M, Staicu IM, www.metabolism.ro – Research Metabolism Center, Bucharest, Romania Carol Davila Military Hospital, Bucharest, Romania", Carol Davila Military Hospital, Bucharest, Romania, "www.metabolism.ro – Research Metabolism Center, Bucharest, Romania Carol Davila Military Hospital, Bucharest, Romania ". Progress and Challenges of Diabetic Foot Diagnostic and Treatment. ROMANIAN JOURNAL OF MILITARY MEDICINE 2023. [DOI: 10.55453/rjmm.2023.126.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
"Diabetic foot is one of the main long-term complications of diabetes, having a significant impact on a patient’s quality of life. However, prevention by daily checking of the limbs and observance of the rules of care remains particularly important to avoid total or partial amputation. This paper aims to highlight the main challenges and progress in the treatment of the diabetic foot. To achieve this, we analyzed a database consisting of more than 100 articles published in recent years, approaching the treatment of the diabetic foot. The main problems that occur with the diabetic foot are peripheral vascular disease and diabetic neuropathy. These can lead to blisters and skin lesions that can eventually lead to ulcers in the lower limbs and even amputation. In conclusion, prevention is the main method of treatment for diabetic foot, followed by the treatment of each complication depending on when it is identified and its severity. "
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16
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Pallin JA, Van Netten JJ, Kearney PM, Dinneen SF, Buckley CM. Do we screen, examine or assess to identify the "at-risk" foot in diabetes-time for agreed terms and definitions? Diabet Med 2023; 40:e14976. [PMID: 36251428 PMCID: PMC10092276 DOI: 10.1111/dme.14976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/14/2022] [Accepted: 09/28/2022] [Indexed: 12/01/2022]
Affiliation(s)
| | - Jaap J Van Netten
- Amsterdam UMC Location University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Program Rehabilitation, Amsterdam, the Netherlands
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Sean F Dinneen
- School of Medicine, National University of Ireland Galway, Galway, Ireland
- Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland
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17
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Influence of Health Education on Podiatric Knowledge, Self-care, and Conditions in Adults With Diabetes Mellitus: A Systematic Review. Adv Skin Wound Care 2022; 35:675-679. [PMID: 36179316 DOI: 10.1097/01.asw.0000884328.49506.7a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine if health education has an influence on podiatric knowledge, self-care, and conditions in adults with diabetes mellitus. DATA SOURCES The authors conducted a literature search for Spanish-, English-, and Portuguese-language publications using PubMed, Scopus, Dialnet, and CUIDEN. STUDY SELECTION Selected keywords related to diabetes, health education, (diabetic) foot, and self-care were searched, and the titles, abstracts, and relevant full-text articles were screened. Thirteen studies were selected with a total of 1,296 participants. Four were randomized controlled trials, and nine were quasi-experimental studies. DATA EXTRACTION Data pertaining to preventive intervention and study outcomes were extracted. DATA SYNTHESIS The preventive interventions used varied from traditional educational workshops and one-on-one patient education to new technological strategies. Three different outcomes were evaluated in each study: podiatric knowledge (n = 4), foot self-care (n = 13), and foot problems (n = 2). CONCLUSIONS Health education interventions increase podiatric self-care in adults with diabetes mellitus. These interventions appear to contribute positively to foot health and podiatric knowledge.
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18
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Zhang S, Ge G, Qin Y, Li W, Dong J, Mei J, Ma R, Zhang X, Bai J, Zhu C, Zhang W, Geng D. Recent advances in responsive hydrogels for diabetic wound healing. Mater Today Bio 2022; 18:100508. [PMID: 36504542 PMCID: PMC9729074 DOI: 10.1016/j.mtbio.2022.100508] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
Poor wound healing after diabetes mellitus remains a challenging problem, and its pathophysiological mechanisms have not yet been fully elucidated. Persistent bleeding, disturbed regulation of inflammation, blocked cell proliferation, susceptible infection and impaired tissue remodeling are the main features of diabetic wound healing. Conventional wound dressings, including gauze, films and bandages, have a limited function. They generally act as physical barriers and absorbers of exudates, which fail to meet the requirements of the whol diabetic wound healing process. Wounds in diabetic patients typically heal slowly and are susceptible to infection due to hyperglycemia within the wound bed. Once bacterial cells develop into biofilms, diabetic wounds will exhibit robust drug resistance. Recently, the application of stimuli-responsive hydrogels, also known as "smart hydrogels", for diabetic wound healing has attracted particular attention. The basic feature of this system is its capacities to change mechanical properties, swelling ability, hydrophilicity, permeability of biologically active molecules, etc., in response to various stimuli, including temperature, potential of hydrogen (pH), protease and other biological factors. Smart hydrogels can improve therapeutic efficacy and limit total toxicity according to the characteristics of diabetic wounds. In this review, we summarized the mechanism and application of stimuli-responsive hydrogels for diabetic wound healing. It is hoped that this work will provide some inspiration and suggestions for research in this field.
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Affiliation(s)
- Siming Zhang
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, China
| | - Gaoran Ge
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China
| | - Yi Qin
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China
| | - Wenhao Li
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China
| | - Jiale Dong
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, China
| | - Jiawei Mei
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, China
| | - Ruixiang Ma
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, China
| | - Xianzuo Zhang
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, China
| | - Jiaxiang Bai
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China
| | - Chen Zhu
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, China,Corresponding author.
| | - Weiwei Zhang
- Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, China,Corresponding author.
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China,Corresponding author.
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Wang Y, Wang Y, Wang X, Zhao Y, Ruan S, Cao H. Effect of leukocyte-platelet fibrin-rich wound reconstruction followed by full-thickness skin grafting in the treatment of diabetic foot Wagner grade 4 ulcer gangrene (toe area). Platelets 2022; 34:2131752. [PMID: 36210791 DOI: 10.1080/09537104.2022.2131752] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study investigated the effect of L-PRF on promoting full-thickness skin grafting for the treatment of diabetic foot ulcer wounds and attempted to characterize the mechanism. In a retrospective study, we centrifugated 10-20 ml of venous blood at 1006.2 g for 20 min. The fibrin clot between the top oligocellular plasma layer and the bottom erythrocyte layer was extracted and directly used, without compression, to cover the wound after debridement. Patients who received L-PRF before skin grafting underwent surgery earlier than patients in the control group. Skin necrosis occurred in 7 patients (28%) in the L-PRF group and 16 (64%) in the control group. The difference was statistically significant, P < .05. The postoperative infection rate in the control group (56%) was significantly higher than that in the L-PRF group (24%), P < .05. During a mean follow-up of 1 year, ulcer recurrence occurred in 9 patients (36%) in the control group compared with 4 patients (16%) in the L-PRF group, P < .05. The final amputation rate was also higher in the control group (48%) than in the L-PRF group (20%). The difference is statistically significant, P < .05. The Maryland scale score and SF-36 score of the two groups of patients after treatment were significantly better than those before treatment, and the difference was statistically significant (P < .05). The L-PRF group (94.80 ± 4.14) had better foot scores at the last follow-up after treatment than the control group (88.84 ± 5.22) (P < .05). The results showed that L-PRF played a positive role in the treatment of Wagner grade 4 ulcer gangrene with free full-thickness skin grafts.
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Affiliation(s)
- Yuqi Wang
- Department of Orthopedic Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China.,Orthopedic Center, Jinzhou Medical University Union Training Base, Shiyan 442000, Hubei, P.R. China
| | - Yanyan Wang
- College of Life Sciences, Wuhan University, Wuhan, Hubei, China
| | - Xiaotao Wang
- Department of Microscopic Hand and Foot Orthopedics, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China, and
| | - Yi Zhao
- Orthopedic Center, Jinzhou Medical University Union Training Base, Shiyan 442000, Hubei, P.R. China.,Department of Plastic and Burn, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Siyuan Ruan
- Department of Orthopedic Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Hong Cao
- Department of Orthopedic Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P.R. China
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Ng CG, Cheong CYW, Chan WC, Ho SWL, Phua MSLA, Anuar K. Diagnostic thresholds for absolute systolic toe pressure and toe-brachial index in diabetic foot screening. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:143-148. [PMID: 35373237 DOI: 10.47102/annals-acadmedsg.2021384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Identifying peripheral arterial disease (PAD) during diabetic foot screening (DFS) is crucial in reducing the risk of diabetic foot ulcerations and lower limb amputations. Screening assessments commonly used include absolute systolic toe pressure (ASTP) and toe-brachial index (TBI). There is a lack of research defining the threshold values of both assessment methods. We aimed to compare the accuracy of ASTP and TBI and establish optimal threshold values of ASTP and TBI with reference to the internationally accepted ankle-brachial pressure index (ABPI) screening test, for a multiethnic diabetic population in Singapore. METHODS A retrospective, observational study of DFS results from January 2017 to December 2017 was conducted. Receiver operating characteristic analysis was conducted for ASTP and TBI using the internationally accepted ABPI cut-off value of ≤0.9 to indicate PAD. RESULTS A total of 1,454 patients with mean (standard deviation) age of 63.1 (12.4) years old were included. There were 50.8% men and 49.2% women, comprising 69.7% Chinese, 13.5% Indian, 10.1% Malay and 6.7% other ethnicities. Areas under the curve for ASTP and TBI were 0.89 (95% confidence interval [Cl] 0.85-0.94) and 0.94 (95% Cl 0.90-0.98), respectively, and the difference was statistically significant (P<0.001). Derived optimal threshold values to indicate ABPI≤0.9 for ASTP and TBI were <95.5mmHg (specificity 0.86, sensitivity 0.84) and <0.7 (specificity 0.89, sensitivity 0.95), respectively. CONCLUSION ASTP or TBI may be used to detect ABPI-determined PAD in DFS. The optimal threshold values derived from a multiethnic Asian diabetic population were <95.5mmHg for ASTP and <0.7 for TBI.
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Affiliation(s)
- Chuan Guan Ng
- Podiatry Service, Foot Care and Limb Design Centre, Tan Tock Seng Hospital, Singapore
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21
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Oral Health Status of Children Living with Type 1 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010545. [PMID: 35010805 PMCID: PMC8744624 DOI: 10.3390/ijerph19010545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 02/04/2023]
Abstract
Background: Diabetes is a well-known predisposing factor for oral diseases, so prevention in an early age is mandatory. Objective: To provide oral screening for children living with type 1 diabetes. We aimed to investigate the oral and general health indexes of T1DM children and compare these data to healthy siblings and controls. Methods: In this cross-sectional study, 120 DM patients and 78 siblings, thereafter 80 DM children and 95 controls, took part. A detailed questionnaire, panoramic radiographs, and lateral cephalograms were obtained in every orthodontic consultation. We used Pearson’s chi-square test for statistical analysis and compared the data of the study and control groups. Results: The oral health values of DM children were significantly better (DMF-T 0.83–1.3) than the national average (3.8–4.5). A total of 75% (n = 60) of the children needed orthodontic treatment for orthodontic or skeletal anomalies. The prevalence of skeletal anomalies was significantly (p < 0.05) higher among patients with diabetes mellitus (DM) than in the control group. The frequency of coeliac disease was significantly elevated compared to any literature data (1–3.5%) in the study (15%) and in the control sibling group (13%). Conclusions: Co-morbidities such as CD should get more attention as a prognostic factor for a future higher incidence of diabetes. T1DM children can be motivated and health-conscious patients with excellent oral hygiene and dental status. Orthodontic treatment can help eliminate the oral complications of DM. Special diabetes ambulances may help provide oral care for patients with DM.
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Liu P, Jin K, Zong Y, He M, Lu C, Li H, Wang Y, Li C. Ionic liquid functionalized injectable and conductive hyaluronic acid hydrogels for the efficient repair of diabetic wounds under electrical stimulation. Biomater Sci 2022; 10:1795-1802. [DOI: 10.1039/d2bm00026a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The treatment and care of diabetic wounds remains a global challenge due to the the high rates of amputation, recurrence, and mortality. It has been proven that electrical stimulation has...
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Nalisa DL, Moneruzzaman M, Changwe GJ, Mobet Y, Li LP, Ma YJ, Jiang HW. Stem Cell Therapy for Diabetic Foot Ulcers: Theory and Practice. J Diabetes Res 2022; 2022:6028743. [PMID: 36524153 PMCID: PMC9747315 DOI: 10.1155/2022/6028743] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Diabetic foot ulcers are associated with increases in limb amputation, morbidity, and mortality. Recently, a stem cell application is emerging as promising adjuvant therapy. We presented available remedies by conducting a literature review on the application, safety, and efficacy of stem cell therapy. Relevant literature, including randomized control trials and article journals, was obtained from reputable search engines (PubMed, Scopus, and Web of Science). We analyzed five credible cohorts, with variable sources of stem cells, in a total of 216 participants, 151 males and 65 females, age (mean ± SD) of 64.5 ± 9.6 years. With an average success of 86.41% in all Wagner-II lesions, mesenchymal SCA (stem cell application) is safe and effective, hence can significantly prevent limb amputation.
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Affiliation(s)
- David Lubasi Nalisa
- Department of Metabolism and Endocrinology, Endocrine and Metabolic Disease Center, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China 471003
- Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang, China 471003
- Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, Luoyang, China 471003
| | - Md. Moneruzzaman
- Department of Rehabilitation Medicine and Physiotherapy, Qilu Hospital of Shandong University, Shandong University, Jinan, Shandong 250012, China
| | - Geoffrey J. Changwe
- Department of Cardiovascular and Thoracic Surgery, National Heart Hospital, Off-Airport Road, 10101 Lusaka, Zambia
| | - Youchaou Mobet
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China
| | - Li Ping Li
- Department of Metabolism and Endocrinology, Endocrine and Metabolic Disease Center, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China 471003
- Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang, China 471003
- Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, Luoyang, China 471003
| | - Yu Jin Ma
- Department of Metabolism and Endocrinology, Endocrine and Metabolic Disease Center, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China 471003
- Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang, China 471003
- Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, Luoyang, China 471003
| | - Hong Wei Jiang
- Department of Metabolism and Endocrinology, Endocrine and Metabolic Disease Center, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China 471003
- Medical Key Laboratory of Hereditary Rare Diseases of Henan, Luoyang, China 471003
- Luoyang Sub-Center of National Clinical Research Center for Metabolic Diseases, Luoyang, China 471003
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Stefanopoulos S, Ayoub S, Qiu Q, Ren G, Osman M, Nazzal M, Ahmed A. Machine learning prediction of diabetic foot ulcers in the inpatient population. Vascular 2021; 30:1115-1123. [PMID: 34461765 DOI: 10.1177/17085381211040984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The objective of this study was to create an algorithm that could predict diabetic foot ulcer (DFU) incidence in the in-patient population. MATERIALS AND METHODS The Nationwide Inpatient Sample datasets were examined from 2008 to 2014. The International Classification of Diseases 9th Edition Clinical Modification (ICD-9-CM) and the Agency for Healthcare Research and Quality comorbidity codes were used to assist in the data collection. Chi-square testing was conducted, using variables that positively correlated with DFUs. For descriptive statistics, the Student T-test, Wilcoxon rank sum test, and chi-square test were used. There were six predictive variables that were identified. A decision tree model CTREE was utilized to help develop an algorithm. RESULTS 326,853 patients were noted to have DFU. The major variables that contributed to this diagnosis (both with p < 0.001) were cellulitis (OR 63.87, 95% CI [63.87-64.49]) and Charcot joint (OR 25.64, 95% CI [25.09-26.20]). The model performance of the six-variable testing data was 79.5% (80.6% sensitivity and 78.3% specificity). The area under the curve (AUC) for the 6-variable model was 0.88. CONCLUSION We developed an algorithm with a 79.8% accuracy that could predict the likelihood of developing a DFU.
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Affiliation(s)
- Stavros Stefanopoulos
- Department of Surgery, College of Medicine and Life Sciences, 7923University of Toledo, Toledo, OH, USA
| | - Samar Ayoub
- Department of Surgery, College of Medicine and Life Sciences, 7923University of Toledo, Toledo, OH, USA
| | - Qiong Qiu
- Department of Surgery, College of Medicine and Life Sciences, 7923University of Toledo, Toledo, OH, USA
| | - Gang Ren
- Department of Surgery, College of Medicine and Life Sciences, 7923University of Toledo, Toledo, OH, USA
| | - Mohamed Osman
- Department of Surgery, College of Medicine and Life Sciences, 7923University of Toledo, Toledo, OH, USA
| | - Munier Nazzal
- Department of Surgery, College of Medicine and Life Sciences, 7923University of Toledo, Toledo, OH, USA
| | - Ayman Ahmed
- Department of Surgery, College of Medicine and Life Sciences, 7923University of Toledo, Toledo, OH, USA
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Akça Doğan D, Enç N. The effect of using a reminder diabetic foot mirror on foot checking frequency and development of diabetic foot in people with diabetes. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Seo DK. Etiology, diagnosis, complications, and treatments of diabetic foot. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.8.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Diabetic foot is one of the complications of diabetes mellitus, accompanied by infection, ulcer, deformity, and neuropathic arthropathy. The prevalence of diabetic foot is approximately 10% to 20% in adult diabetic patients over 30 years. Patients with diabetic foot show decreased life quality due to long-term treatment and hospital admission for various complications. Therefore, it is important to understand the etiology of diabetic foot and to prevent the accompanying complications.Current Concepts: Multiple complications of diabetic foot such as ulcers, infections, and deformities are derived from neuropathy (sensory, motor, and autonomic nerves) and angiopathy. Careful physical and radiologic examinations and laboratory evaluations are necessary to diagnose diabetic foot. Dressings, surgical decompressions, antibiotics, and vascular interventions are helpful for the treatment of ulcers in diabetic foot. Maintaining proper blood glucose levels and medication help control the neuropathies. Furthermore, patients should be educated on careful foot care to prevent complications.Discussion and Conclusion: Diabetic foot and its accompanying complications are difficult to treat and decrease patients’ quality of life. To prevent complications of diabetic foot, management of blood glucose, patient education on self-foot care, screening of high-risk factors, and cooperation of various medical specialists are needed.
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Foo CD, Surendran S, Tam CH, Ho E, Matchar DB, Car J, Koh GCH. Perceived facilitators and barriers to chronic disease management in primary care networks of Singapore: a qualitative study. BMJ Open 2021; 11:e046010. [PMID: 33947737 PMCID: PMC8098912 DOI: 10.1136/bmjopen-2020-046010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The increasing chronic disease burden has placed tremendous strain on tertiary healthcare resources in most countries, necessitating a shift in chronic disease management from tertiary to primary care providers. The Primary Care Network (PCN) policy was promulgated as a model of care to organise private general practitioners (GPs) into groups to provide GPs with resources to anchor patients with chronic conditions with them in the community. As PCN is still in its embryonic stages, there is a void in research regarding its ability to empower GPs to manage patients with chronic conditions effectively. This qualitative study aims to explore the facilitators and barriers for the management of patients with chronic conditions by GPs enrolled in PCN. DESIGN We conducted 30 semistructured interviews with GPs enrolled in a PCN followed by a thematic analysis of audio transcripts until data saturation was achieved. SETTING Singapore. RESULTS Our results suggest that PCNs facilitated GPs to more effectively manage patients through (1) provision of ancillary services such as diabetic foot screening, diabetic retinal photography and nurse counselling to permit a 'one-stop-shop', (2) systematic monitoring of process and clinical outcome indicators through a chronic disease registry (CDR) to promote accountability for patients' health outcomes and (3) funding streams for PCNs to hire additional manpower to oversee operations and to reimburse GPs for extended consultations. Barriers include high administrative load in maintaining the CDR due to the lack of a smart electronic clinic management system and financial gradient faced by patients seeking services from private GPs which incur higher out-of-pocket expenses than public primary healthcare institutions. CONCLUSION PCNs demonstrate great promise in empowering enrolled GPs to manage patients with chronic conditions. However, barriers will need to be addressed to ensure the viability of PCNs in managing more patients in the face of an ageing population.
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Affiliation(s)
- Chuan De Foo
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Shilpa Surendran
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Chen Hee Tam
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Elaine Ho
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - David Bruce Matchar
- Internal Medicine, Duke University, Durham, North Carolina, USA
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Gerald Choon Huat Koh
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University Singapore, Singapore
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Zhao Y, Cai K, Wang Q, Hu Y, Wei L, Gao H. Effect of tap dance on plantar pressure, postural stability and lower body function in older patients at risk of diabetic foot: a randomized controlled trial. BMJ Open Diabetes Res Care 2021; 9:9/1/e001909. [PMID: 33737414 PMCID: PMC7978263 DOI: 10.1136/bmjdrc-2020-001909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/25/2021] [Accepted: 02/28/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION To examine the effects of tap dance (TD) on dynamic plantar pressure, static postural stability, ankle range of motion (ROM), and lower extremity functional strength in patients at risk of diabetic foot (DF). RESEARCH DESIGN AND METHODS A randomised, single-blinded, two-arm prospective study of 40 patients at risk of DF was conducted. The intervention group (n=20) received 16 weeks of TD training (60 min/session×3 sessions/week). The control group attended four educational workshops (1 hour/session×1 session/month). Plantar pressure, represented by the primary outcomes of peak pressure (PP) and pressure-time integral (PTI) over 10 areas on each foot, was measured using the Footscan platform system. Secondary outcomes comprised static postural stability, ankle ROM and lower extremity functional strength. RESULTS Reductions in intervention group PP (right foot: mean differences=4.50~27.1, decrease%=25.6~72.0; left foot: mean differences=-5.90~6.33, decrease%=-22.6~53.2) and PTI at 10 areas of each foot (right foot: mean differences=1.00~12.5, decrease%=10.4~63.6; left foot: mean differences=0.590~25.3, decrease%=21.9~72.6) were observed. Substantial PP and PTI differences were noted at the second through fourth metatarsals, medial heel and lateral heel in the right foot. Substantial PP and PTI differences were detected at metatarsals 1 and 2 and metatarsal 2 in the left foot, respectively. Moderate training effects were found in plantar flexion ROM of both feet, lower extremity functional strength, and length of center-of-pressure trajectory with eyes closed and open (r=0.321-0.376, p<0.05). CONCLUSIONS A 16-week TD training program can significantly improve ankle ROM, lower extremity functional strength, and static postural stability. To attain greater improvements in plantar pressure, a longer training period is necessary. TRIAL REGISTRATION NUMBER ChiCTR1800014714.
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Affiliation(s)
- Yanan Zhao
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, China
| | - Keshu Cai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qianwen Wang
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, China
| | - Yaqing Hu
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, China
| | - Lijun Wei
- Maigaoqiao Community Health Service Center, Nanjing, China
| | - Huihua Gao
- Xigang Community Health Service Center, Nanjing, China
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Wang H, Xu Z, Zhao M, Liu G, Wu J. Advances of hydrogel dressings in diabetic wounds. Biomater Sci 2021; 9:1530-1546. [DOI: 10.1039/d0bm01747g] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The hydrogel dressings with various functions for diabetic wound treatment.
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Affiliation(s)
- Heni Wang
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province
- School of Biomedical Engineering
- Sun Yat-sen University
- Guangzhou
- PR China
| | - Zejun Xu
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province
- School of Biomedical Engineering
- Sun Yat-sen University
- Guangzhou
- PR China
| | - Meng Zhao
- Shenzhen Lansi Institute of Artificial Intelligence in Medicine
- Shenzhen
- China
| | - Guiting Liu
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province
- School of Biomedical Engineering
- Sun Yat-sen University
- Guangzhou
- PR China
| | - Jun Wu
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province
- School of Biomedical Engineering
- Sun Yat-sen University
- Guangzhou
- PR China
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Howarth D. Preventing foot complications in people with diabetes mellitus. Nurs Stand 2020; 34:69-74. [PMID: 31468824 DOI: 10.7748/ns.2019.e11432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2019] [Indexed: 12/19/2022]
Abstract
'Diabetic foot' is a term used to describe a group of syndromes in which neuropathy and/or ischaemia lead to tissue breakdown and reduced resistance to infection in a patient with diabetes mellitus. Foot ulceration is a serious and potentially limb-threatening complication of diabetes that can lead to pain, tissue necrosis and amputation, and may significantly affect an individual's well-being and mobility. Foot complications also have wider economic implications for healthcare services. Therefore, it is important to reduce the risk of foot complications through regular foot assessments and providing patient education and appropriate referral to specialist services. This article discusses foot complications in people with diabetes, outlining the causes, signs and symptoms, and associated risk factors. It also outlines the assessment and prevention measures that patients and healthcare practitioners can take to reduce the risk of foot complications.
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White F. Application of Disease Etiology and Natural History to Prevention in Primary Health Care: A Discourse. Med Princ Pract 2020; 29:501-513. [PMID: 32422632 PMCID: PMC7768156 DOI: 10.1159/000508718] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/17/2020] [Indexed: 11/19/2022] Open
Abstract
The principles of etiology and natural history of disease are essential to recognizing opportunities for prevention across the illness spectrum. They have a bearing on how illness is experienced, how differently it can be perceived at the time of first contact with the health system, and how it may appear at later stages. Opportunities for prevention arise at every stage in the process, and three main levels are described: primary, secondary, and tertiary. Prevention strategies include health promotion focused on determinants, clinical prevention to reduce modifiable risk factors, case finding, screening, and addressing functional outcomes relevant to quality of life; the importance of preventing errors is also recognized. The distinction between incidence effects and treatment effects of prevention is explored. This review also examines the differing roles of language in health science and public communication, aspects of disease classification, related issues in patient-centered care, the prevention paradox, and integrated models of disease prevention.
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Affiliation(s)
- Franklin White
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada,
- Pacific Health and Development Sciences, Victoria, British Columbia, Canada,
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Dalla Paola L, Cimaglia P, Carone A, Boscarino G, Scavone G. Use of Integra Dermal Regeneration Template for Limb Salvage in Diabetic Patients With No-Option Critical Limb Ischemia. INT J LOW EXTR WOUND 2020; 20:128-134. [PMID: 32056470 DOI: 10.1177/1534734620905741] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We have analyzed in a retrospective study of consecutive diabetic patients affected by no-option critical limb ischemia (CLI) the efficacy of the dermal substitute Integra Dermal Regeneration Template for treatment of complicated foot lesions. The primary end point was limb salvage and 1-year amputation-free survival. The secondary end point was healing time of surgical site. Between October 2014 and October 2017, 1024 patients with diabetic foot ulcer (DFU) and CLI were admitted. In 84 patients (8.2%), there was a failure in distal revascularization with a persistent CLI after the procedure. Despite the persistent CLI, a group of 26 patients of this cohort obtained complete wound healing. Among them, 13 patients were treated with surgical debridement or open amputations and application of dermal substitute Integra Dermal Regeneration Template and the other 13 patients were treated without any dermal substitute. The Integra group healed within a mean time of 83.5 days, and the control group healed within a mean of 139 days (P = .028). No major amputation was carried out at 1-year follow-up in the Integra group versus 15% in the control group. A conservative foot surgery or an approach with minor amputation in diabetic patients with no-option CLI may achieve limb salvage. The use of Integra Dermal Regeneration Template in patients with DFU and no-option CLI may be a useful option in a limb salvage program.
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Affiliation(s)
| | | | - Anna Carone
- Maria Cecilia Hospital, Cotignola, Ravenna, Italy
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Sukartini T, Theresia Dee TM, Probowati R, Arifin H. Behaviour model for diabetic ulcer prevention. J Diabetes Metab Disord 2020; 19:135-143. [PMID: 32550163 DOI: 10.1007/s40200-019-00484-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 12/27/2019] [Indexed: 01/27/2023]
Abstract
Purpose Diabetic ulcers are one of the complications that often occur in patients with DM. The aim is to develop a behaviour model for diabetic ulcer prevention by integrating Lawrance Green Theory and the Theory of Planned Behaviour. Methods An explanative observational design was used with a cross-sectional approach. The population consisted of DM patients who had underwent treatment at the internal medicine clinic of Sidoarjo District Hospital. The sample size of 133 respondents was obtained through purposive sampling. The data analysis used Partial Least Square. Results Predisposing factors (knowledge), supporting factors (availability of health facilities and accessibility of health resources) and driving factors (the role of health workers and family support) significantly influence the main factors (attitudes toward behaviour, subjective norms and perceptions of self-control) with a statistical T value>1.96. The main factor influences intention (T = 48.650) and intention influences behaviour (T = 4.891). Conclusion Intention is influenced by the attitudes toward behaviour, subjective norms and self-control perceptions. Good intentions can increase the preventive behaviour related to diabetic ulcers. Increasing the diabetic ulcer prevention behaviour can be done by providing regular education to both the patients and their families about diabetic ulcers and their prevention through the appropriate management of DM, lifestyle modification and regular foot care that requires active involvement from the family and health care workers.
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Affiliation(s)
- Tintin Sukartini
- Department of Fundamental, Medical-Surgical and Critical Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | | | - Ririn Probowati
- Sekolah Tinggi Ilmu Kesehatan Pemkab Jombang, Jombang, Indonesia
| | - Hidayat Arifin
- Master's of Nursing Study Program, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
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Cabeceira HDS, de Souza DMST, Juliano Y, Veiga DF. Work ability and productivity in patients with diabetic foot. Clinics (Sao Paulo) 2019; 74:e421. [PMID: 30916210 PMCID: PMC6424068 DOI: 10.6061/clinics/2019/e421] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 12/19/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To assess work ability and productivity in patients with diabetic foot. METHODS This investigation was a cross-sectional controlled study. A total of 117 individuals were selected from March to June 2014 and allocated to group A (patients without diabetes, n=43), group B (diabetes patients without foot ulcers, n=43), or group C (patients with diabetic foot, n=31). Two validated instruments, the Work Limitations Questionnaire (WLQ) and the Work Productivity and Activity Impairment Questionnaire General Health v2.0 (WPAI-GH), were used to assess work ability and productivity. RESULTS The groups were homogeneous regarding age and sex; however, patients in group C had a lower education level than the other participants (p=0.006). The median WLQ scores for groups A, B, and C were 0.0121, 0.0146, and 0.0852, respectively (p<0.0001). The WPAI-GH scores revealed a mean productivity loss of 20% for groups A and B and 100% for group C (p<0.0001). CONCLUSIONS Patients with diabetic foot showed decreased work ability and productivity.
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Affiliation(s)
- Helga dos Santos Cabeceira
- Mestrado Profissional em Ciencias Aplicadas a Saude, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
| | - Diba Maria Sebba Tosta de Souza
- Departamento de Enfermagem, Mestrado Profissional em Ciencias Aplicadas a Saude, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
- *Corresponding author. E-mail:
| | - Yara Juliano
- Departamento de Bioestatistica, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
| | - Daniela Francescato Veiga
- Divisao de Cirurgia Plastica, Mestrado Profissional em Ciencias Aplicadas a Saude, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
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