scholarly journals Preliminary Evaluation of a Cycling Cleat Designed for Diabetic Foot Ulcers

2017 ◽  
Vol 107 (6) ◽  
pp. 475-482 ◽  
Author(s):  
Ryan T. Crews ◽  
Steven R. Smith ◽  
Ramin Ghazizadeh ◽  
Sai V. Yalla ◽  
Stephanie C. Wu
Keyword(s):  
Blood Flow ◽  
Diabetic Foot ◽  
Plantar Pressure ◽  
Tissue Perfusion ◽  
Foot Ulcers ◽  
Preliminary Evaluation ◽  
Diabetic Foot Ulcers ◽  
Time Integral ◽  
Traditional Health ◽  
Before And After

Background: Offloading devices for diabetic foot ulcers (DFU) generally restrict exercise. In addition to traditional health benefits, exercise could benefit DFU by increasing blood flow and acting as thermotherapy. This study functionally evaluated a cycling cleat designed for forefoot DFU. Methods: Fifteen individuals at risk of developing a DFU used a recumbent stationary bicycle to complete one 5-minute cycling bout with the DFU cleat on their study foot and one 5-minute bout without it. Foot stress was evaluated by plantar pressure insoles during cycling. Laser Doppler perfusion monitored blood flow to the hallux. Infrared photographs measured foot temperature before and after each cycling bout. Results: The specialized cleat significantly reduced forefoot plantar pressure (9.9 kPa versus 62.6 kPa, P < .05) and pressure time integral (15.4 versus 76.4 kPa*sec, P < .05). Irrespective of footwear condition, perfusion to the hallux increased (3.97 ± 1.2 versus 6.9 ± 1.4 tissue perfusion units, P < .05) after exercise. Infrared images revealed no changes in foot temperature. Conclusions: The specialized cleat allowed participants to exercise with minimal forefoot stress. The observed increase in perfusion suggests that healing might improve if patients with active DFU were to use the cleat. Potential thermotherapy for DFU was not supported by this study. Evaluation of the device among individuals with active DFU is now warranted.

scholarly journals Meningkatkan motivasi dan efikasi diri penderita diabetes tipe 2 dalam pencegahan kaki diabetik menggunakan dukungan kelompok

2020 ◽  
Vol 13 (4) ◽  
pp. 292-300
Author(s):  
Suyanto Suyanto ◽  
Dwi Sulistyowati
Keyword(s):  
Diabetic Foot ◽  
Self Efficacy ◽  
Foot Ulcers ◽  
P Value ◽  
Diabetic Foot Ulcers ◽  
Group Support ◽  
Foot Care ◽  
Type 2 Diabetics ◽  
Before And After

Improving motivation and self-efication of type 2 diabetics in prevention of diabetic foot ulcers and infections using group supportBackground: Management of DM (Diabetics) patients according to expectations requires a variety of support, one of them is group support such as the Persadia Club as an organization that helps people with diabetes to manage disease conditions become more controlled. Through group support, motivation and self-efficacy which are important factors in diabetes care behavior will increase. Thus the main action in the prevention of diabetic foot in the form of routine foot care will be carried out by the person with diabetes optimally.Purpose: To determine the effect of group support on motivation and self-efficacy of type 2 diabetics in prevention of diabetic foot ulcers and infectionsMethods: The study design was a quasi-experimental one pre group test one group method to see if there were differences in motivation and self-efficacy in diabetic foot care before and after group support. The study was conducted in May to August 2019 at the Surakarta City Persada Club as a population and a sample of 135 respondentResults: Research shows that there are differences in the self-efficacy of people with diabetes before and after getting group support with p value = 0,000. Thus the hypothesis that the influence of group support on self-efficacy is accepted. Furthermore, the results obtained that there are differences in motivation to take preventive measures for diabetes feet between before and after group support is given with a p value = 0,000. This means that the hypothesis that there is an influence of group support on motivation for diabetic foot prevention.Conclusion: As a suggestion, it is expected that people with diabetes through the Persadia club will always be supported so that their motivation and efficacy is high so that the diabetic foot care measures will be optimally carried out. Keywords: Motivation; Self-Efication; Type 2 Diabetics; Prevention; Diabetic Foot Ulcers and Infections; Group SupportPendahuluan: Pengelolaan pasien DM (Diabetisi) yang sesuai harapan memerlukan berbagai dukungan salah satu diantaranya yaitu dukungan kelompok seperti Club persadia sebagai organisasi yang membantu para diabetisi untuk mengelola kondisi penyakit  menjadi lebih terkontrol. Melalui dukungan kelompok  maka motivasi dan efikasi diri yang merupakan faktor penting dalam perilaku perawatan diabetes akan meningkat. Dengan demikian tindakan utama dalam  pencegahan kaki diabetik berupa tindakan perawatan kaki secara rutin akan dilakukan para diabetisi dengan optimal.Tujuan: Untuk mengetahui pengaruh dukungan kelompok terhadap motivasi dan efikasi diri  penderita diabetes tipe 2 dalam pencegahan kaki diabetikMetode : Rancangan penelitian berupa kuasi eksperimen dengan metode pre post test one group untuk melihat apakah terdapat perbedaan  motivasi dan  efikasi diri dalam tindakan perawatan kaki diabetik sebelum dan sesudah mendapat dukungan kelompok.  Penelitian dilakukan pada bulan Mei hingga Agustus 2019 pada Club Persadia Kota Surakarta  sebagai populasi dan diambil sampel sebanyak 135 respondenHasil: Penelitian menunjukkan bahwa terdapat perbedaan efikasi diri para diabetisi sebelum dan sesudah mendapt dukungan kelompok dengan p value = 0,000,  Dengan demikian hipotesis terdapat pengaruh dukungan kelompok terhadap efikasi diri diterima. Selanjutnya diperoleh hasil bahwa terdapat perbedaan motivasi melakukan tindakan perawatan pencegahan kaki diabetes antara sebelum dan sesudah diberikan dukungan kelompok dengan nilai p value= 0,000.  Hal ini berarti hipotesis terdapat pengaruh dukungan kelompok terhadap motivasi tindakan perawatan pencegahan kaki diabetis.Simpulan: Sebagai saran diharapkan para diabetisi melalui club Persadia selalu diberi dukungan agar motivasi dan efikasi dirinya tinggi sehingga tindakan perawatan kaki diabetik akan optimal dilakukan

Correlation of HDL cholesterol serum and Wagner’s severity level of diabetic foot ulcers

2017 ◽  
Vol 5 (12) ◽  
pp. 5129 ◽  
Author(s):  
Tommy Kartono ◽  
Muhammad Nuralim Mallapasi ◽  
Mulawardi Mulawardi ◽  
Sachraswaty R. Laidding ◽  
Meiliati Aminyoto ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Hdl Cholesterol ◽  
Foot Ulcers ◽  
P Value ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional ◽  
Severity Level ◽  
Before And After

Background: Diabetic foot ulcers are one of the leading causes of amputation in non-traumatic patients. This research aimed to investigate the correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification. The study conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia.Methods: This is an observational study with the cross-sectional design. The data collected before and after the treatment. The change of the levels of HDL cholesterol and the severity level of the diabetic foot ulcer based on Wagner classification during the treatment were analyzed. Data analyzed using Spearman Correlation test, the paired t-test to assess the change in the levels of HDL cholesterol and the levels of severity of diabetic foot ulcer based on Wagner classification at the time admission and after the treatment.  ANOVA test was used to observe the reduction significance of the severity of diabetic foot ulcer based on Wagner classification, and it was categorized as significant if p<0.05.Results: The results indicated that there is a correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification either at the early treatment with p-value = 0.003 (r = - 0.448) and the end of the treatment with p-value = 0.001(r = - 0.477).  The lower of the level of cholesterol HDL, the higher was the severity level of the diabetic foot ulcer. Meanwhile, the correlation between the increase of the level of HDL cholesterol and the reduction of Wagner classification during the treatment was statistically insignificant with p-value = 0.100 (r = - 0.215).Conclusions: there was a correlation between elevated HDL cholesterol levels during treatment with Wagner classification decrease during treatment, the higher the HDL change, the higher the Wagner classification, but this was weak correlation and statistically insignificant.

scholarly journals Finite Element Analysis of Cushioned Diabetic Footwear Using Ethylene Vinyl Acetate Polymer

Polymers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 2261
Author(s):  
Mariyam J. Ghazali ◽  
Xu Ren ◽  
Armin Rajabi ◽  
Wan Fathul Hakim W. Zamri ◽  
Nadia Mohd Mustafah ◽  
...  
Keyword(s):  
Finite Element ◽  
Vinyl Acetate ◽  
Diabetic Foot ◽  
Plantar Pressure ◽  
Ethylene Vinyl Acetate ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Foot Pressure ◽  
Treatment And Prevention ◽  
Foot Model

With the development of societies, diabetic foot ulcers have become one of the most common diseases requiring lower extremity amputation. The early treatment and prevention of diabetic foot ulcers can considerably reduce the possibility of amputation. Using footwear to redistribute and relieve plantar pressure is one of the important measures for the treatment and prevention of diabetic foot ulcers. Thus, the evaluation and prediction of the distribution of plantar pressure play an important role in designing footwears. Herein, the finite element method was used to study plantar pressure under two kinds of foot models, namely, the skeletal structure foot model and the whole foot model, to explore the influence of human bones on the pressure of the soles of the feet and obtain accurate foot pressure. Simulation results showed that under the two models, the plantar pressure and the pressure from the footwear with ethylene vinyl acetate were all reduced. The total deformation demonstrated a slight increase. These stresses are very useful as they enable the design of suitable orthotic footwear that reduces the amount of stress in individuals with diabetic foot ulcers.

scholarly journals PEDIS Score Analysis in Diabetic Foot Ulcer following Angioplasty Revascularization Procedure

2021 ◽  
Vol 2 (1) ◽  
pp. 20-25
Author(s):  
Ridho Sinaga ◽  
Djony Tjandra ◽  
Richard Sumangkut ◽  
Billy Karundeng ◽  
Fima Langi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Tissue Loss ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vascular Disorders ◽  
Score Analysis ◽  
Before And After ◽  
Artery Disease

Background: Diabetic foot ulcers (DFU) is one of the major health care problems. Diabetic foot ulcers are a combination of vascular and non-vascular disorders. Vascular disorders that occur in the form of diabetic angiopathy which can be in the form of macro angiopathy if the condition occurs in large blood vessels, and micro angiopathy if it occurs in arterioles and capillaries. Revascularization can be done minimally invasive and has become the gold standard in the management of chronic limb ischemic (CLI). WHO recommends Perfusion, Extent / Size, Depth / Tissue Loss, Infection, Sensation (PEDIS) classification to diagnose and to determine the management of diabetic foot. We conduct a study to find out whether there are improvements in the PEDIS score of diabetic foot ulcer patients post angioplasty Methods: This study was designed in the form of a quasi-experiment, in which measurements before and after treatment were carried out on patients with diabetic foot ulcers (DFU) who underwent revascularization angioplasty without any measurement for control patients. From November 2019 to September 2020, there were 48 cases of diabetic foot ulcer with peripheral artery disease (PAD) who underwent angioplasty. Before the procedure, a clinical evaluation and calculation of the PEDIS score were carried out then angioplasty was performed, after the procedure the PEDIS score was calculated and evaluated in the first, second and third weeks. Results: The PEDIS scores of the patients prior to angioplasty had a median score of 8 (IQR 7; 9). Post-procedure the median quantity fell to 6 on both the immediate post angioplasty and two weeks afterward measurement with the width of the IQR narrowing slightly at the last measurement. The male patients’ PEDIS scores did not differ relatively from those of the female patients at the three measurement times, and their scores were almost identical to the scores for the patients as a whole. Conclusion: The results of this study indicate that there is an improvement in the PEDIS score in diabetic foot ulcer patients after revascularization angioplasty.

scholarly journals Effectiveness of topical insulin in the management of diabetic foot ulcers.

2019 ◽  
Vol 26 (09) ◽  
pp. 1487-1490
Author(s):  
Shafaatullah ◽  
Sadaf Iqbal ◽  
Bushra Zulfiqar ◽  
Shayan Zufishan
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Blood Glucose ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Ulcer Size ◽  
Before And After ◽  
Mean Size ◽  
The Mean

Introduction: Diabetes mellitus is one of the most common metabolic disorders affecting a large part of our population. Apart from its effect on all organ systems, these metabolic derangements affect other processes in the body as well. Diabetic wounds are difficult to treat with conventional treatments. Delayed wound healing has led to increased morbidity and mortality in the population. Increased blood glucose leads to ineffective angiogenesis and less collagen deposition. In various studies long acting insulin zinc suspension has been shown to augment wound healing without any harmful effects. Objectives: To find out the advantages of topical insulin in the management of diabetic foot ulcers. Study Design: Observational study. Setting: Plastic Surgery and General Surgery Department, Baqai Medical University Karachi. Period: January 2014 to December 2016. Material and Methods: Patients visiting the Surgical OPD with diabetes mellitus and concomitantly having foot ulcers were included in the study. Diabetics having blood glucose levels of 110-130 gm/dl and ulcers measuring more than one cm on the dorsum of the foot were included in the study. All patients having foot ulcers were treated by daily topical spray of 1cc saline mixed with 5 units of insulin. This treatment was continued for 12 weeks or till the time ulcer was completely healed (whichever was earlier) and ulcer size was measured weekly. Ulcer size and depth before and after treatment was measured. Results: We had a total of 65 participants, among them there were 52 males and 13 females presenting with diabetic foot ulcer. Around 87.6% (n=57) patients had type 2 diabetes mellitus whereas 12.3% (n=8) patients had type 1 diabetes mellitus. Upon examination of the patient the location, size and depth of the ulcer was measured as well. These parameters were measured before and after treatment by topical insulin spray. Right foot ulcers were present in 64.6% of the patients and 35.38% patients had left foot ulcers. The mean size and depth of ulcer was 5.1 + 1.1 cm2 and 8.7 + 0.12 mm respectively. After treatment the mean size and depth of ulcer was found to be 1 + 0.04cm2 and 1.4 + 0.12mm respectively. Conclusion: There was significant improvement after treatment of diabetic foot ulcers with topical insulin spray. The wound size and depth were considerably decreased. This treatment had more promising results than conventional treatment methods for diabetic foot ulcers.

scholarly journals Clinical, pathomorphological and immunohistochemical evaluation of tissue repair in diabetic foot ulcers

2019 ◽  
Vol 21 (6) ◽  
pp. 490-496 ◽  
Author(s):  
Alla Y. Tokmakova ◽  
Ekaterina L. Zaitseva ◽  
Iya A. Voronkova ◽  
Marina V. Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Tissue Repair ◽  
Chronic Wounds ◽  
Soft Tissues ◽  
Local Treatment ◽  
Surgical Debridement ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Before And After

Background: It is known that wound healing is Impaired in diabetes mellitus. Possible reasons are widely being searched. However, despite all the available data, reliable markers of reparative processes in diabetes mellitus are needed to be found. Aim: To study morphological and some immunohistochemical markers of tissue repair in patients with diabetic foot ulcers after local treatment. Materials and methods: 70 patients with diabetic foot ulcers before and after surgical debridement were included. Histological (light microscopy) and immunohistochemical (CD68, MMP-9, TIMP-1) characteristics of tissue repair processes in soft tissues of the lower extremities in patients with diabetes mellitus were analyzed. Histological and immunohistochemical examination of soft tissues were performed in 63 patients before and after surgical debridement and 10 days after local treatment. Results: After the surgical debridement a significant reduction in the area of wounds was registered by 23.4% (p 0.05), wound depth by 29.4% (p 0.05). Based on the results of the morphological study, the presence of mature granulation tissue in the wounds was confirmed. Immunohistochemical study of wound biopsies demonstrated a significant decrease in proteolytic activity in the wound as a decrease in MMP-9 expression (p 0.05). Statistically significant changes in the number of macrophages against the initial data were not found, as well as increased expression of TIMP-1 was observed (p 0.05 and 0.05, respectively). Conclusion: According to the data, there was a significant decrease in the area and depth of wounds during local treatment. The intensity of tissue repair was confirmed by the results of histological and immunohistochemical studies. However, the absence of a statistically significant change in the amount of macrophages on the background of treatment suggests that this repair link is disrupted in diabetes mellitus, which is the reason for the "chronic" wounds and requires further studies.

Clinical performance evaluation of a newly developed sock for people with diabetes

2021 ◽  
pp. 095441192110020
Author(s):  
Berna Cüreklibatır Encan ◽  
Arzu Marmaralı ◽  
Dilek Bayraktar ◽  
Şevki Çetinkalp ◽  
Ilgın Yıldırım Şimşir
Keyword(s):  
Diabetic Foot ◽  
Plantar Pressure ◽  
Clinical Performance ◽  
Fungal Infections ◽  
Callus Formation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Metatarsal Bones ◽  
Patients With Diabetes ◽  
Diabetic Wounds

Diabetes mellitus (DM) is a chronic disease that has become a global health problem. As the population of people with diabetes is growing worldwide, the prevalence of complications associated with DM, such as diabetic foot, also increases. Neuropathy and high plantar pressure are the two most frequent causes of foot ulceration. Since diabetic wounds tend to heal slowly, it is crucial to prevent diabetic foot ulcers before they occur. In this study, the efficacy of a sock developed for diabetes in the previous research of the authors was investigated in a clinical study with the participation of patients with diabetes over a 6-month period. At the end of the study, it was observed that none of the participants had experienced any new ulcers, bacterial or fungal infections, or callus formation during this research. Moreover, a slight decrease in pressure was observed for the first, second, and third metatarsal bones when the socks were worn on day 1. On the other hand, pressure reduction was identified for the fourth and fifth metatarsal bones in all following measurements. However, analyses revealed that duration of usage did not have a statistically significant effect on overall plantar pressure. It was also found that pressure on the fourth and fifth metatarsal bones significantly decreased. Assessment of wearing comfort revealed the satisfaction of the patients, as well. Based on the promising outcomes of this clinical evaluation, these socks developed for people with diabetes can be strongly expected to help avoid diabetic foot ulcers.

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