scholarly journals M.I. Akhunbaev, A.P. Kalinin, D.S. Rafibekov. Diabetic angiopathy of the lower extremities and diabetic foot. - Bishkek, 1997 .-- 143 p.

2019 ◽  
Vol 45 (1) ◽  
pp. 56-56
Author(s):  
M. N. Solun
Keyword(s):  
Diabetes Mellitus ◽  
Adverse Effect ◽  
Diabetic Foot ◽  
Lower Extremities ◽  
Premature Death ◽  
Diabetic Angiopathy ◽  
Patients With Diabetes

The monograph under review is devoted to one of the most important sections of clinical diabetology. As you know, damage to the lower extremities in patients with diabetes mellitus (DM) is quite common and has an adverse effect on the fate of patients, causing their early disability, and in some cases premature death.

scholarly journals Morphological research of the effectiveness of perioperative local use of anesthetics and antiseptics in patients with purulent-necrotic lesions of lower extremities in diabetes mellitus

2021 ◽  
Vol 27 (3) ◽  
pp. 22-28
Author(s):  
Yu.M. Babina ◽  
D.V. Dmyrtriiev ◽  
O.A. Nazarchuk ◽  
P.P. Hormash
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Granulation Tissue ◽  
Diabetic Foot ◽  
Povidone Iodine ◽  
Local Treatment ◽  
Lower Extremities ◽  
Diabetic Foot Syndrome ◽  
Patients With Diabetes ◽  
Infiltration Anesthesia

Ulcer-necrotic lesions of the feet are detected in 5-15% of patients with diabetes mellitus (DM). According to the literature today in Ukraine, patients with DM perform high amputation of the lower extremities with diabetic foot syndrome with a frequency of 19.6-42.6%, at the same time, mortality ranges from 8.9% to 25.0%, and the total mortality rate at the DM varies from 6.6% to 13.5%, often associated with the occurrence of postoperative complications. The aim of the work was to study morphological indicators of reparation of soft tissues of the lower extremities in patients with diabetic foot syndrome on the background of local treatment during the perioperative period. We investigated changes in histologic structure and character of reactions of skin tissues, muscles and fascia during the period of visceral disease in patients with diabetes mellitus after different types of local treatment. Then, samples of skin tissues, muscles and fascia were photographed and analyzed using a light microscope OLIMPUS BX 41. In the first group of the comparison, which used standard methods of anesthesia and local antiseptic povidone-iodine, granulation tissue was characterized by the complete absence of fibrous structures (collagen fibers) and the presence of a small number of newly formed small diameter vessels with blistered endothelium. Vessels of young granulation tissue were dilated, full-blooded, the endothelium was swollen, there was significant perivascular edema. In the second group of patients (where povidone-iodine and infiltration anesthesia with 2% lidocaine solution anesthetic was used locally) there were almost no remains of necrotic tissues in the affected tissues. It should be noted that there was better granulation development with fewer inflammatory-cell elements, more young forms of fibroblasts and a moderate pathological vascular reaction. In the first (control) group, wound healing by 3-7 days is characterized by somewhat slow regeneration. Wound healing was most favorable in patients of the second group, where infiltration anesthesia was used by local anesthetic and antiseptic povidone-iodine.

scholarly journals The process of repair of trophic ulcers in patients with diabetes

2004 ◽  
Vol 50 (2) ◽  
pp. 34-38
Author(s):  
N. A. Myskina ◽  
A. Yu. Tokmakova ◽  
M. B. Antsiferov
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Diabetic Foot ◽  
Neurological Disorders ◽  
Sharp Increase ◽  
Lower Extremities ◽  
Late Complications ◽  
Diabetic Foot Syndrome ◽  
Industrialized Countries ◽  
Patients With Diabetes

In the last 30 years, there has been a sharp increase in the incidence of diabetes mellitus (DM), especially in industrialized countries, and its prevalence tends to further increase [3]. The main cause of disability and death of patients are late complications of this disease. Among them, it is especially important to identify developing diabetic foot syndrome (DFS), which is defined as infection, ulcer and / or destruction of deep tissues, associated with neurological disorders and decreased main blood flow in the arteries of the lower extremities of varying degrees severity (International Diabetic Foot Agreement, Netherlands, 1999)

Penerapan Pengaruh Senam Kaki Diabetes Terhadap Nilai Ankle Brachial Index (Abi) Pada Pasien Diabetes Mellitus Tipe 2

2021 ◽  
Vol 1 ◽  
pp. 813-819
Author(s):  
Jihan Astrie ◽  
S Sugiharto
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Healthcare Providers ◽  
Ankle Brachial Index ◽  
Premature Death ◽  
Foot Care ◽  
12 Steps ◽  
Patients With Diabetes ◽  
Sugar Levels ◽  
And Function

AbstractDiabetes mellitus is a disease characterized by high blood sugar levels due to disruption of the production and function of the hormone insulin. One of the symptoms of diabetes mellitus is a decrease in foot sensitivity which is characterized by a tingling and thick feeling in the feet. This study aims to apply diabetic foot exercise and its effect on the value of the ankle brachial index (ABI) in patients with diabetes mellitus. The research design was a case study on 2 patients with type 2 diabetes mellitus. The instruments used were vascular doppler, jelly, gauze/tissue, sphygmomanometer, bent, and stationery. The intervention by applying diabetes foot exercise 12 steps with a duration of 30 minutes was carried out 3 times a week. The results showed an increase in the ABI value in both patients with an average increase of 0.2. In addition, the patient said that the tingling and thick feeling in the legs decreased. Thus, it is proven that diabetic foot exercise can increase the ABI value in patients with diabetes mellitus. Suggestions for healthcare providers to assess patient knowledge related to diabetic foot exercise, and teach the patient. Foot care is one of the diabetes self-care pillars that can prevent complications and reduce premature death among diabetic patients.Keywords: Ankle Brachial Index;Diabetes Mellitus; Diabetes Foot Exercise AbstrakDiabetes mellitus merupakan penyakit yang ditandai dengan tingginya kadar gula darah akibat terganggunya produksi dan fungsi hormon insulin. Salah satu gejala diabetes mellitus yaitu penurunan sensitivitas kaki yang ditandai dengan rasa kesemutan dan tebal pada kaki. Penelitian ini bertujuan untuk mengaplikasikan senam kaki diabetes dan pengaruhnya terhadap nilai ankle brachial index (ABI) pada pasien diabetes mellitus. Desain penelitian berupa studi kasus pada 2 pasien diabetes mellitus tipe 2. Instrumen yang digunakan berupa doppler vaskuler, jelly, kassa/tissue, sphygmomanometer, bengkok, dan alat tulis. Intervensi dengan mengaplikasikan senam kaki diabetes 12 langkah dengan durasi 30 menit dilakukan selama 3 kali dalam seminggu. Hasil menunjukan terjadi peningkatan nilai ABI pada kedua pasien dengan rata – rata peningkatan 0,2. Selain itu pasien mengatakan rasa kesemutan dan tebal pada kaki sudah berkurang. Dengan demikian, terbukti bahwa senam kaki diabetes dapat meningkatkan nilai ABI pada pasien diabetes mellitus. Saran bagi pelayanan kesehatan untuk mengkaji pengetahuan pasien terkait dengan senam kaki diabetes, dan mengajarkannya. Karena perawatan kaki merupakan salah satu pilar perawatan diabetes mandiri yang dapat mencegah komplikasi dan menurunkan kematian dini akibat diabetes. Kata kunci: Ankle Brachial Index;Diabetes Mellitus; Senam Kaki Diabetes

STUDY ON THE CHARACTERISTICS OF DOPPLER ULTRASOUND OF LOWER EXTREMITY ARTERIES IN PATIENTS WITH DIABETES MELLITUS TYPE 2

2011 ◽  
pp. 25-30
Author(s):  
Keyword(s):  
Diabetes Mellitus ◽  
Doppler Ultrasound ◽  
Lower Extremities ◽  
Arterial Stenosis ◽  
Invasive Technique ◽  
Atherosclerotic Plaques ◽  
Type 2 Dm ◽  
Arterial Lesions ◽  
Patients With Diabetes

Objectives: Vascular Doppler ultrasound is a non-invasive technique to rapidly detect lesions of the vessels in the lower extremities with high accuracy. The use of this technique for detecting early vascular damages in patients with diabetes mellitus (DM) type 2 could help preventing major vascular complications caused by this disease. Materials and Method: This descriptive, cross-sectional study included 31 patients with type 2 DM who were treated in Endocrinology - Neurology - Respiratory Department, Hue Central Hospital between March and August 2011. All patients were undergone clinical and biochemical examinations, and Doppler ultrasound for detection of arterial lesions in their lower extremities. Results: Most patients had high intima media thickness (IMT) (77.42%), and all of them suffered from hypertension concomitant, with the rate of atherosclerotic plaque accounted for 35.48%. No one experienced arterial stenosis >50% and arterial occlusions, but the peak systolic velocities were significantly higher in patients with atherosclerotic plaques than those without atherosclerotic plaques. Conclusion: Vascular Doppler ultrasound should be used as routine test for early detection of arterial lesions in patients with type 2 DM.

scholarly journals Glycated Hemoglobin (HbA1c) as a Biomarker for Diabetic Foot Peripheral Neuropathy

Diseases ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Giulia Casadei ◽  
Marta Filippini ◽  
Lorenzo Brognara
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Glycated Hemoglobin ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Glycemic Variability ◽  
Future Research ◽  
Patients With Diabetes ◽  
Axonal Dysfunction ◽  
Biomarker Research

Background: Diabetic peripheral neuropathy (DPN) is known to predict foot ulceration, lower-extremity amputation and mortality. Patients with diabetes mellitus have a predisposition toward developing chronic inflammatory demyelinating polyneuropathy, and this may also facilitate the formation of diabetic foot and cutaneous impairment, which are considered one of the most serious impairments of diabetes mellitus, with a prevalence of 4–10% in this population. Biomarkers research provides opportunities for the early diagnosis of these complications for specific treatments useful to prevent amputation and, therefore, physical inability and mental disturbance. The recent literature has suggested that glycemic levels may be a novel factor in the pathogenesis of diabetic foot complications and is an important mediator of axonal dysfunction. The aim of this systematic literary review is to determine whether hemoglobin A1c (HbA1c) is a positive predictor for diabetic foot peripheral neuropathy and its complications, such as foot cutaneous impairments. There is a lack of consensus regarding the effect of glycemic variability on diabetic foot peripheral neuropathy, unlike other complications such as retinopathy, nephropathy or micro/macrovascular pathology. Methods: Relevant articles were searched in the Medline database using PubMed and Scopus and relevant keywords. The primary search terms used were “glycated hemoglobin” OR “HbA1c” AND “diabetic neuropathies” AND “Foot”. Results: A number of articles (336) were initially identified while searching the scientific literature regarding this topic, and 32 articles were selected and included in this review. Conclusions: This review highlights the role of HbA1c in diabetic foot peripheral neuropathy. Biomarkers play an important role in the decision-making process, and HbA1c levels are extensively used for diabetic foot clinical outcomes and settings, but biomarker research in diabetic foot peripheral neuropathy is in its infancy and will require careful attention to a number of factors and associations, since the consequences of DPN also include neurological alterations. HbA1c is an accurate and easy-to-administer test and can be an effective biomarker in establishing the diagnosis of diabetes, but future research should focus on standardizing the HbA1c level and selecting which DPN value and its correlated complications, such as foot cutaneous impairments, are the most informative.

scholarly journals Quantifying dermal microcirculatory changes of neuropathic and neuroischemic diabetic foot ulcers using spatial frequency domain imaging: a shade of things to come?

2020 ◽  
Vol 8 (2) ◽  
pp. e001815
Author(s):  
Grant A Murphy ◽  
Rajinder P Singh-Moon ◽  
Amaan Mazhar ◽  
David J Cuccia ◽  
Vincent L Rowe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Spatial Frequency ◽  
Oxygen Saturation ◽  
Diabetic Foot ◽  
Clinical Course ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Spatial Frequency Domain Imaging ◽  
Patients With Diabetes ◽  
Spatial Frequency Domain

IntroductionThe use of non-invasive vascular and perfusion diagnostics are an important part of assessing lower extremity ulceration and amputation risk in patients with diabetes mellitus. Methods for detecting impaired microvascular vasodilatory function in patients with diabetes may have the potential to identify sites at risk of ulceration prior to clinically identifiable signs. Spatial frequency domain imaging (SFDI) uses patterned near-infrared and visible light spectroscopy to determine tissue oxygen saturation and hemoglobin distribution within the superficial and deep dermis, showing distinct microcirculatory and oxygenation changes that occur prior to neuropathic and neuroischemic ulceration.Research designs and methods35 patients with diabetes mellitus and a history of diabetic foot ulceration were recruited for monthly imaging with SFDI. Two patients who ulcerated during the year-long longitudinal study were selected for presentation of their clinical course alongside the dermal microcirculation biomarkers from SFDI.ResultsPatient 1 developed a neuropathic ulcer portended by a focal increase in tissue oxygen saturation and decrease in superficial papillary hemoglobin concentration 3 months prior. Patient 2 developed bilateral neuroischemic ulcers showing decreased tissue oxygen saturation and increased superficial papillary and deep dermal reticular hemoglobin concentrations.ConclusionsWounds of different etiology show unique dermal microcirculatory changes prior to gross ulceration. Before predictive models can be developed from SFDI, biomarker data must be correlated with the clinical course of patients who ulcerate while being followed longitudinally.Trial registration numberNCT03341559.

Surgical Off-loading of the Diabetic Foot

2010 ◽  
Vol 100 (5) ◽  
pp. 369-384 ◽  
Author(s):  
Robert G. Frykberg ◽  
Nicholas J. Bevilacqua ◽  
Geoffrey Habershaw
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Foot ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Foot Ulcers ◽  
Foot Surgery ◽  
Patients With Diabetes

Surgical intervention for chronic deformities and ulcerations has become an important component in the management of patients with diabetes mellitus. Such patients are no longer relegated to wearing cumbersome braces or footwear for deformities that might otherwise be easily corrected. Although surgical intervention in these often high-risk individuals is not without risk, the outcomes are fairly predictable when patients are properly selected and evaluated. In this brief review, we discuss the rationale and indications for diabetic foot surgery, focusing on the surgical decompression of deformities that frequently lead to foot ulcers. (J Am Podiatr Med Assoc 100(5): 369–384, 2010)

scholarly journals Possibilities of combined surgical treatment of pyonecrotic lesions in the neuroischemic form of diabetic foot syndrome

2009 ◽  
Vol 12 (1) ◽  
pp. 8-13
Author(s):  
Valeriy Afanas'evich Mitish ◽  
I A Eroshkin ◽  
Gagik Radikovich Galstyan ◽  
Lyudmila Petrovna Doronina ◽  
Yu S Paskhalova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diabetic Foot ◽  
Lower Extremities ◽  
Lower Leg ◽  
Diabetic Foot Syndrome ◽  
Diagnostic Tools ◽  
Critical Ischemia ◽  
Adequate Treatment ◽  
Patients With Diabetes ◽  
Foot Lesions

Aim. To present results of combined surgical treatment of the ischemic form of diabetic foot syndrome complicated by pyonecrotic process. To show thatthe use of modern diagnostic tools and the choice of adequate treatment strategy permits to substantially reduce the number of above-the-knee amputations. Materials and methods. A total of 140 patients with diabetes mellitus and critical ischemia of lower extremities were under observation during 2004-2008.All of them had purulent and/or necrotic foot lesions. The patients were examined by X-ray, computed and magneto-resonance tomography of the feet,duplex scanning of lower leg vasculature, transcutaneous measurement of PO2, pelvic and lower leg arterial angiography. Results. A strategy of surgical treatment was developed to be used depending on the patients health status, clinical features and severity of pyonecroticprocesses in the foot, and the degree of involvement of the main blood vessels of lower extremities. Conclusion. Combination of endovascular surgery with various methods for plastic wound closure permits to extend the range of possibilities for the treatmentof high-risk patients, such as those with pyonecrotic lesions and neuroischemic form of diabetic foot syndrome. This approach opens up prospects fora significant decrease of percentage of above-the-knee amputations and improves the quality of life in these patients.

Effectiveness of various materials in reducing plantar shear forces. A pilot study

2000 ◽  
Vol 90 (7) ◽  
pp. 346-353 ◽  
Author(s):  
M Curryer ◽  
ED Lemaire
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Diabetic Foot ◽  
Shear Force ◽  
Foot Ulcers ◽  
Shear Forces ◽  
Patients With Diabetes ◽  
Force Data ◽  
Precipitating Factor ◽  
Better Than

Vertical plantar forces are known to be a major precipitating factor in the development of foot pathology. It is also postulated that shear forces are important in the pathogenesis of foot ulcers in patients with diabetes mellitus. Various materials are used in insoles designed to reduce forces on the foot. While many foam materials have been tested for their ability to dissipate vertical forces, few studies have tested the effect of these materials on shear forces. This study assessed the effectiveness of five different materials in reducing plantar shear forces and compared two new gel materials with three of the more conventional foam materials. Four subjects were tested while walking over a force platform with one of the five materials taped to the surface. Peak force, impulse, and resultant shear force data were analyzed. The gel materials were significantly better than the foam materials at reducing shear forces. Thus the use of gel materials in insoles may be indicated for the reduction of plantar shear forces on the diabetic foot.

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