scholarly journals Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot

2012 ◽  
Vol 28 ◽  
pp. 218-224 ◽  
Author(s):  
N. C. Schaper ◽  
G. Andros ◽  
J. Apelqvist ◽  
K. Bakker ◽  
J. Lammer ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Working Group ◽  
Foot Ulcer ◽  
Arterial Disease ◽  
Progress Report ◽  
Diagnosis And Treatment ◽  
Diabetic Patients ◽  
International Working Group ◽  
Peripheral Arterial

scholarly journals Risk of Diabetic Foot in Diabetic Patients with Peripheral Arterial Disease

2020 ◽  
Vol 18 (1) ◽  
pp. 38-41
Author(s):  
A. Joshi
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Medical Sciences ◽  
Institutional Review ◽  
Peripheral Arterial ◽  
Ethical Clearance

Background The prevalence of peripheral arterial disease is higher in diabetic patients. And 11.6% of the patients with diabetic foot ulcer have associated peripheral arterial disease. Objective The main objective of the study is to assess the risk of diabetic foot in diabetic patients with peripheral arterial disease. Method This was a case control study conducted in Bir Hospital, National Academy of Medical Sciences (NAMS). The sample size was 173 out of which cases (diabetic foot) and unmatched controls (diabetics without diabetic foot) were divided in the ratio of 1:2. The Odds Ratio (OR) of peripheral arterial disease in diabetic foot was calculated. The study was conducted after taking ethical clearance from Institutional Review Board of National Academy of Medical Sciences. Result There were 173 participants enrolled in the study. Four were excluded, 55 participants were cases of diabetic foot (cases) and 114 participants were diabetics without diabetic foot (controls). The odds of diabetic foot in patients with peripheral arterial disease was 4.12, p < 0.001. Conclusion The risk of diabetic foot in diabetic patients with peripheral arterial disease was higher as compared to diabetic patients without peripheral arterial disease.

scholarly journals MON-683 Assessment of Features Associated with Diabetic Foot Risk in General Hospital in Lima-Peru

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marlon Augusto Yovera-Aldana ◽  
Sonia Helen Perez-Cavero ◽  
Candy Ivoone Sipiran ◽  
Haydee Barrios ◽  
Eduardo Callacna ◽  
...  
Keyword(s):  
At Risk ◽  
Peripheral Neuropathy ◽  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Working Group ◽  
Arterial Disease ◽  
Older Age ◽  
International Working Group ◽  
History Of ◽  
Peripheral Arterial

Abstract Objectives: To determine the frequency of diabetic foot risk of ulceration and associated factors in patients with type 2 diabetes mellitus. Methods and materials: We used a cross-sectional descriptive design. Data collection was performed in the foot at risk office at Maria Auxiliadora hospital over a period of 3 years, dating from the october 2016 to september 2019. Foot risk assessment was based on the International Working Group of Diabetic Foot (IWGDF) system, which evaluates peripheral neuropathy (with monofilament or tuning fork), biomechanical deformity, peripheral arterial disease (altered pulse or ankle branchial index) or a history of foot ulcer1,2. Foot risk frequency was found according to epidemiological characteristics, and the prevalence ratios with 95% confidence interval were calculated to association analysis, we perform bivariate and multivariate analysis using a generalized linear model. This study has the approval of the María Auxiliadora HospitaĹs Ethics Committee. Results: a total of 402 subjects were included in this study, 63.3% were women, average age 62 yo and diabetes duration &lt;10 years in 56%. 76.6% presented risk to develop ulcer, of which 54.7% presented biomechanical deformation, 37.3% Peripheral Neuropathy (NP), 35.4% Peripheral Arterial Disease (PAD), and 12.7% history of foot ulcer. Patients with foot at risk were associated with older age (RP 1,006, 95% CI 1,001-1.01), and with a score&gt; 5 with respect to &lt;5 in the Total Symptom Score (RP 1.26, 95% CI 1.05-1.51). Conclusions: 3 of 4 patients have a foot at risk of ulceration, predominantly due to biomechanical deformation and peripheral neuropathy, and this risk was associated with older age and greater pain symptomatology. References 1. Bakker K, Apelqvist J, Schaper NC. Practical Guidelines on the management and prevention of the diabetic foot 2011. International Working Group on the Diabetic Foot Guidelines. Diabetes Metab Res Rev. 2012; 28(1):225-231 2. Peters E, Lavery L. Effectiveness of the Diabetic Foot Risk Classification System of the International Working Group on the Diabetic Foot. Diabetes Care. 2001 24:1442–7.

Prevalence of Peripheral Arterial Disease in Diabetic Foot Ulcer Patients and its Impact in Limb Salvage

2021 ◽  
pp. 153473462110270
Author(s):  
Ahmed Azhar ◽  
Magdy Basheer ◽  
Mohamed S. Abdelgawad ◽  
Hossam Roshdi ◽  
Mohamed F. Kamel
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Diabetic Foot ◽  
Negative Impact ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Limb Amputation ◽  
Cross Sectional ◽  
Peripheral Arterial

Diabetic foot ulcer syndrome is a common complication of diabetes mellitus. Three main factors contribute to it: neuropathy, vasculopathy, and infection. This study was conducted to evaluate the prevalence of peripheral arterial disease (PAD) in diabetic foot ulcer patients and its impact on limb salvage as an outcome. This prospective cross-sectional study included 392 cases, who were divided according to the presence of PAD into 2 groups; patients with PAD were labeled as PAD +ve (172 cases) and those without PAD were labeled as PAD −ve (22 cases). All cases were clinically assessed, and routine laboratory examinations were ordered. Moreover, duplex ultrasound was done for suspected cases of having PAD by examination. Computed tomography angiography was ordered for patients who are in need of a revascularization procedure. Cases were managed by debridement and/or revascularization. After that, these cases were assessed clinically and radiologically for vascularity and infection and the possibility for amputation was evaluated. Infection was classified using Wagner Classification System, and revascularization was decided according to the TASC II system. The incidence of PAD in cases with diabetic foot ulcer syndrome was 43.87%. No difference was detected between the 2 groups regarding age and gender ( P > .05). The prevalence of smoking, hemodialysis, ischemic heart disease (IHD), and hypertension was more significantly higher in cases with PAD ( P < .05). Revascularization procedures were only performed in cases that had documented severe PAD or chronic limb-threatening ischemia in addition to foot ulcer and/or infection. With regard to limb salvage, it was more significantly performed in cases without PAD (82.3% vs 48.3% in PAD cases; P < .001). Male gender, smoking, ankle-brachial pressure index, hemodialysis, IHD, neuropathy, HbA1C, PAD, and high Wagner classification were predictors of limb amputation ( P < .05). PAD is associated with worse outcomes in diabetic foot ulcer patients. Not only does it constitute a great number among diabetic foot ulcer patients, but it also has a negative impact on limb salvage.

scholarly journals Características Clínicas E Imagenológicas De Los Pacientes Con Úlcera Por Pie Diabético Con Tratamiento Endovascular De La Enfermedad Periférica Arterial. Marzo 2015 a Junio 2017.

2019 ◽  
Vol 38 (3) ◽  
Author(s):  
Jossuett Barrios ◽  
Bernardino Denis ◽  
Gilberto Chanis
Keyword(s):  
Peripheral Arterial Disease ◽  
Endovascular Treatment ◽  
Foot Ulcer ◽  
Arterial Disease ◽  
Primary Patency ◽  
Diabetic Patients ◽  
Anterior Tibial Artery ◽  
Below The Knee ◽  
Imaging Characteristics ◽  
Peripheral Arterial

<p>[Clinical and radiological Characteristics of patients with diabetic foot ulcer with endovascular treatment of peripheral arterial disease. March 2015 to June 2017.]</p><p><br /><strong>Resumen</strong><br />Introducción: La Diabetes mellitus es un problema global, y junto a sus complicaciones representa la causa líder de muerte por enfermedades no transmisibles. El 50% de los pacientes con Diabetes presentan signos de compromiso vascular que al complicarse ameritan tratamiento con bypass quirúrgico que es el método convencional, pero se ha visto que la técnica endovascular ha ayudado a disminuir la morbilidad y la mortalidad de estos pacientes, reduciendo además, el número de amputaciones mayores en los pacientes con pie diabético y enfermedad arterial periférica Objetivo: Describir características clínicas e imagenológicas de pacientes diabéticos con tratamiento endovascular de la enfermedad periférica arterial. Metodología: Estudio descriptivo retrospectivo mediante revisión de expedientes clínicos y radiológicos. Utilizando un formulario para la recolección de datos y EpiInfo v7.2 para la creación y análisis la base de datos. Resultados: Participaron 50 pacientes, el 52% pertenecían al sexo femenino, la mayoría de los pacientes pertenecían al grupo de los 61-70 años. La hipertensión arterial fue la comorbilidad más frecuente (78%). La enfermedad arterial por debajo de la rodilla fue la más observada, con afectación de la arteria tibial anterior principalmente (84%). La angioplastia con balón se realizó en el 100% de los casos, con falló en el 8% de los casos. Conclusión: La enfermedad arterial periférica afecta en mayor medida a los vasos de la pierna por debajo de la rodilla. El tratamiento endovascular de las lesiones arteriales periféricas constituye un método con una gran tasa de éxito en el procedimiento inicial.<br /><br /><strong>Abstract</strong><br />Objective: Describe the clinical and imaging characteristics of diabetic patients who underwent endovascular treatment for peripheral arterial disease. Method: A retrospective descriptive study was carried out. We reviewed the data in the clinical and radiological file of the patients included in the study; they were collected in a survey sheet previously authorized by the Bioethics Committee of the Institution. The data obtained were tabulated in the EpiInfo v7.2 program and graphed using the Office Excel 2016 program. Results: Fifty patients who met the inclusion criteria were included in the study, 52% of them were women, mainly in the age group between 61-70 years. Arterial hypertension was the most frequent comorbidity in the study population with 78% of the total patients. Arterial disease below the knee was more frequent, with involvement of the anterior tibial artery in 84% of the patients evaluated. Balloon angioplasty was performed in 100% of the cases, while stent placement was necessary in 10% of the procedures performed. The result of the procedure was not successful only in 4/50 patients performed. 84% of the patients presented primary patency at 6 months of evaluation. Conclusion: Peripheral arterial disease mainly the vessels of the leg below the knee. Endovascular treatment of peripheral arterial injuries is a safe method with a high success rate in the initial procedure, as well as a low recurrence of intervention at least 6 months after the procedure.<br /><br /></p>

scholarly journals PENATALAKSANAAN ULKUS KAKI DIABETES SECARA TERPADU

2013 ◽  
Vol 3 (2) ◽  
Author(s):  
Yuanita A. Langi
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Peripheral Arterial

Abstract: A diabetic foot ulcer is a common and fearful chronic complication of diabetes mellitus often resulting in amputation, and even death. A diabetic foot ulcer can be prevented by early screening and education in high risk individuals, and the management of underlying conditions such as neuropathy, peripheral arterial disease, and deformity. The prevalence of diabetic foot ulcer patients is 4-10% of the general population, with a higher prevalence in elderly people. Around 14-24 % of diabetic foot ulcer patients need amputations with a recurrence rate of 50% after three years. The main pathogenesis of diabetic foot ulcer is neuropathy and peripheral arterial disease (PAD). PAD contributes to diabetic foot ulcers in 50% of cases; however, it rarely stands alone. Other factors such as smoking, hypertension, and hyperlipidemia may contribute, too. In addition, PAD reduces the access of oxygen and antibiotics to the ulcers. Management of diabetic foot ulcers includes treatment of ischemia by promoting tissue perfusion, debridement for removing necrotic tissues, wound treatment for creating moist wound healing, off-loading the affected foot, surgery intervention, management of the co-morbidities and infections, and prevention of wound recurrences. Other adjuvant modalities include hyperbaric oxygen treatment, GCSF, growth factors, and bioengineered tissues. Key words: diabetic ulcer, debridement, off loading.   Abstrak: Ulkus kaki diabetes (UKD) merupakan salah satu komplikasi kronik diabetes melitus yang sering dijumpai dan ditakuti oleh karena pengelolaannya sering mengecewakan dan berakhir dengan amputasi, bahkan kematian. UKD dapat dicegah dengan melakukan skrining dini serta edukasi pada kelompok berisiko tinggi, dan penanganan penyebab dasar seperti neuropati, penyakit artei perifer dan deformitas. Prevalensi pasien UKD berkisar 4-10% dari populasi umumnya, dengan prevalensi yang lebih tinggi pada manula. Sekitar 14-24% pasien UKD memerlukan amputasi dengan rekurensi 50 % setelah tiga tahun. Patogenesis utama UKD yaitu neuropati dan penyakit arteri perifer (PAP). PAP berkontribusi 50% pada pasien UKD, tetapi hal ini jarang dijumpai tunggal. Terdapat faktor-faktor lain yang turut berperan seperti merokok, hipertensi dan hiperlipidemia. Selain itu PAP menurunkan akses oksigen dan antibiotik ke dalam ulkus. Penatalaksanaan UKD meliputi penanganan iskemia dengan meningkatkan perfusi jaringan, debridemen untuk mengeluarkan jaringan nekrotik, perawatan luka untuk menghasilkan moist wound healing, off-loading kaki yang terkena, intervensi bedah, pananganan komorbiditas dan infeksi, serta pencegahan rekurensi luka. Terapi ajuvan meliputi terapi oksigen hiperbarik, pemberian granulocyte colony stimulating factors (GCSF), growth factors dan bioengineerd tissues. Kata kunci: ulkus diabetes, debridemen, off loading.

scholarly journals Epidemiology and Burden of Diabetic Foot Ulcer and Peripheral Arterial Disease in Korea

2019 ◽  
Vol 8 (5) ◽  
pp. 748 ◽  
Author(s):  
Dong-il Chun ◽  
Sangyoung Kim ◽  
Jahyung Kim ◽  
Hyeon-Jong Yang ◽  
Jae Heon Kim ◽  
...  
Keyword(s):  
Health Care ◽  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Total Population ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Major Amputation ◽  
Using Data ◽  
Peripheral Arterial

Information about the epidemiology of diabetic foot ulcer (DFU) with peripheral arterial disease (PAD) is likely to be crucial for predicting future disease progression and establishing a health care budget. We investigated the incidence and prevalence of DFU and PAD in Korea. In addition, we examined costs of treatments for DFU and PAD. This study was conducted using data from Health Insurance Review and Assessment Service from 1 January 2011 to 31 December 2016. The incidence of DFU with PAD was 0.58% in 2012 and 0.49% in 2016. The prevalence of DFU with PAD was 1.7% in 2011 to 1.8% in 2016. The annual amputation rate of DFU with PAD was 0.95% in 2012 and 1.10% in 2016. Major amputation was decreased, while minor amputation was increased. The direct cost of each group was increased, especially the limb saving group. which was increased from 296 million dollars in 2011 to 441 million dollars in 2016. The overall incidence of DFU with PAD was about 0.5% of total population in Korea, from 2012 to 2016. Furthermore, costs for treatments of diabetic foot ulcer are increasing, especially those for the limb saving group.

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