Showing 11 results for Diabetic Foot
Bagher Larijani, Mohammad Hasan Bastan Hagh, Mohammad Pajouhi, Mojgan Afshari, Mansoureh Khani, Masoumeh Shagareyan,
Volume 1, Issue 1 (7-2001)
Abstract
Background: Diabetes mellitus is a common chronic disorder with multiple disabling long- and shorter-term complications, the majority of which can be controlled if not prevented. The management of diabetic patients is a major drain on both health budgets and time.
Methods: We reviewed the records of 101 patients with diabetic foot ulcer, who had received treatment at either Doctor Shariati or Imam Khomeini hospital.
Results: Out of 101 patients (56.4% male and 43.6% female) with diabetic foot ulcer, 34.7% had eventually undergone amputation.
Conclusion: Our findings highlight the need for control and prevention programmes aimed at reducing the risk factors for and complications of diabetic foot ulcer.
Bagher Larijani, Farshad Forouzandeh,
Volume 2, Issue 2 (6-2003)
Abstract
Diabetes mellitus is characterized by several adverse consequences among which diabetic foot is a major complication.
With a life long incidence of 15%, diabetic foot is accountable for more than 50% of non-traumatic lower limb amputations. Regular care, proper footwear and early treatment, but, have proved effective measures in preventing such outcome.
The problem and features as infection, ulceration, or gangrene. Neuropathy, poor circulation, and decreased resistance to infection are the three major contributors to the development of diabetic foot which when present, foot deformities or minor trauma can readily lead to ulceration and infection.
Not all diabetic foots are preventable, but appropriate preventive measures can dramatically reduce their occurrence.
Farshad Forouzandeh, Alireza Aziz Ahari, Farid Abolhasani, Bagher Larijani,
Volume 4, Issue 4 (6-2005)
Abstract
Background: Foot complications are among the important problems of diabetic patients. Vascular and neurological involvements are two major causes for such complications.
Methods: We studied 142 diabetic outpatients referred to diabetes clinic of Dr.Shariati Hospital from Dec. 2003 to Sep. 2004. We performed different neurological and vascular tests to assess the diabetic foot and data were analyzed by SPSS software.
Results: 54.9% of the cases reached the symptom score of 5 and upper so they had neuropathy regarding the Michigan Neuropathy Disability Score (MNDS). By analyzing the overall symptom and sign scores, 61% had neuropathy. Regarding MNDS, 42.7% of the subjects were neuropathic. Finally 23.9% were unable to sense at least one point from 12 points of monofilament examination. 16.9% of the patients had the complaint of intermittent claudication, in 8.8% at least one of the peripheral pulses was not palpable, whereas 10.6% had some degree of PAD regarding to ABI and toe pressure.
Conclusion: Using a monofilament is the most reliable method for screening of the neuropathy in diabetic patients. On the other hand, relying on symptoms like intermittent claudication and physical examination in order to find peripheral arterial disease in diabetic patients may lead to miss many cases, thus, performing some more precise diagnostic tests, such as ABI and toe pressure are highly recommended and reliable.
Oussama Khatib, Ozra Tabatabaei Malazy,
Volume 7, Issue 2 (9-2007)
Abstract
Diabetes among Eastern Mediterranean (EM) population above age of 20 years is around 10.5% and is ranked among the leading causes of blindness, renal failure and lower limb amputation. While 50% of EM people with diabetes will die of cardiovascular diseases. This means that in our region, there are pandemic trends in prevalence of diabetes and associated complications. Globally, people with diabetes are 25 times more likely to have a leg amputated than those without the condition, and up to 70% of all leg amputations happen to people with diabetes. Somewhere in the world, a leg is lost to diabetes every 30 seconds. Foot ulcer is the most common single precursor to lower extremity amputations among diabetics. Hyperglycemia, impaired immunologic responses, neuropathy, and peripheral arterial disease are the major predisposing factors leading to limb-threatening diabetic foot infections. Diabetic foot represents a health problem and economic burden among majority of EM Countries. Infection in a diabetic foot is limb-threatening and must be treated empirically and aggressively. Treatment of infected foot wounds is the most common reason for diabetes- related hospitalization. The good news is that up to 85 percent of diabetic amputations can be prevented. As to above challenge, the best approach for EMR is education, community awareness and prevention of diabetic foot. The public approach and education that emphasize on proper footwear and foot care are best preventive and cost-effective modalities that can be easily implemented among EM Countries. EM Countries need to strengthen national health services that promote the concept of prevention and tight control of diabetes in order to prevention diabetes complications. This also necessitates building/strengthening diabetes registry and complications.
Alireza Kashefi, Javad Haddadnia,
Volume 14, Issue 5 (7-2015)
Abstract
Background: Diabetic foot ulcers are one of the most common complications of diabetes that affect more than 15 percent of diabetic people. In the other hand, due to problems in the immune system of diabetic patients, these ulcers are often slow to take hold and this dramatically increase the risk of gangrene, amputation and even death. Conventional methods to identify vulnerable areas to ulcers that are based on the examination and palpation of the skin, this usually can’t reveal changes of integrity of the skin at the right time to prevent the ulcers. Therefore in recent years, thermal imaging from the body as a new method to early diagnosis has been considered to be as a ulcers area. This method is based on comparing the left and right feet‘s temperature to identify areas of inflammation occurs.
Methods: In this study from 25 participants feet’s thermal images were taken in the Image Processing Laboratory, University of Hakim Sabzevari at standard conditions and Then The algorithm is fully automatic order to compare the thermal image accurately and extraction of passionate area from the temperature matrix for correspondent comparison of left and right feet‘s temperature Is designed to identify areas of hidden inflammation.
Results: The proposed system is designed based on image processing and computer vision techniques, Able to find two cases of inflammation were among the participants in the study. The accuracy, sensitivity and specificity of the algorithm, respectively equal of 90%, 100% and % 88 achieved.
Conclusion: Unlike past researches that is more for the quality of their action on the thermal images, we managed to design quite a smart system that quantitatively comparing peer to peer parts of the left and right people’ planetary, in order to identify the inflammation area. While the researchers said that when a patient does not feel the monofilament testing and couldn’t noticed the temperature of his/her soles of his/her feet, In fact, the only method to prediction and prevention of creating ulcers in a foot without sense, is detecting the temperature difference, that designed algorithm in this research well and accurately, makes meet The authenticity and acceptability of this demands.
Maryam Mortezaee, Abbasali Raz, Shole Mansouri, Zohreh Annabestani, Zahra Mirzaeezadeh, Bagher Larijani, Mehrdad Hashemi, Kobra Omidfar,
Volume 15, Issue 5 (7-2016)
Abstract
Background: Insulin resistance and progressive β-cells failure are the key factors in type 2 diabetes mellitus (T2DM) pathogenesis. Many studies support a primary role of RBP4 in insulin resistance and suggest that genetic variations which alter the expression level of RBP4 might influence the risk of T2DM and its complications. Diabetic foot is one of the main complications of diabetes leading to disability and hospitalization. In addition, it reduces quality of life and imposes great cost to patients. The purpose of this study was to evaluate the correlation between two single nucleotide polymorphisms (rs10882273 and rs10882283) of RBP4 genes with diabetic foot ulcer in order to identify a biomarker for prediction of diabetic foot ulcer.
Methods: This is a case-control study. Two single nucleotide polymorphisms of RBP4 genes were genotyped by hit Tetra ARMS PCR technique. In this study, 100 and 133 diabetic patients with and without foot ulcer were selected as the cases and controls, respectively.
Results: The Chi-square test revealed no significant difference in frequency of TT, CC and TC alleles of rsl0882273 between case and control groups (P=0.414). Also, Comparison of AA, CC and AC alleles of rsl0882283 in both groups did not show significant difference (P=0.85).
Conclusion: According to this study, there is no relationship between two single nucleotide polymorphisms of RBP4 genes (rs10882273 and rs10882283) with diabetic foot ulcer in type2 diabetes patients.
Sharare Hassanzade, Abbasali Raz, Masoumeh Mansouri, Zahra Mirzaeezadeh, Bagher Larijani, Mehrdad Hashemi, Kobra Omidfar,
Volume 16, Issue 1 (1-2017)
Abstract
Background: Type 2 diabetes is a metabolic disorder characterized by high blood sugar levels that can damage nerves. Many organs are affected ،especially the foot that leading to loss of sensation. These factors make favorable conditions for the development of diabetic foot ulcers. Polymorphisms (Thr399Ile) of Toll Like Receptor4 (TLR4) gene due to malfunction of TLR4 protein which plays an important role in immunity. The purpose of this study was to determine the parameters which are affecting the imbalance resulting in chronic inflammation and wound healing. By showing the relationship between single nucleotide polymorphism (Thr399Ile) of TLR4 gene with diabetic foot ulcer we can identify a biomarker for prediction of diabetic foot ulcer.
Methods: This is a case-control study. Single nucleotide polymorphisms of TLR4 gene were genotyped by hit Tetra ARMS PCR technique. In this study, 100 and 120 diabetic patients with and without foot ulcer were selected as the cases and controls, respectively.
Results: The Chi-square test revealed significant difference in frequency of TT, CC and TC alleles of (Thr399Ile) between case and control groups (P=0.021).
Conclusion: According to this study, there is a relationship between single nucleotide polymorphisms (Thr399Ile) of TLR4 gene with diabetic foot ulcer in type 2 diabetes patients
Sahar Shafiee, Abbasali Raz, Neda Adibi, Masoomeh Mansouri, Zohreh Annabestani, Zahra Mirzaeezadeh, Mehrdad Hashemi, Kobra Omidfar,
Volume 17, Issue 1 (3-2018)
Abstract
Background: Type 2 diabetes is the most common type of diabetes, and a complex endocrine metabolic disorder that one of its main complications is diabetic foot ulcers. Matrix metalloproteinases (MMPs) are one of the key enzymes in the reconstruction of extracellular matrix which have proteolytic activity. The aim of this research is based on evaluating relationship between -1562 C>T allele at MMP-9 gene promoter with diabetic foot ulcer in type II diabetic patients. If such correlation proves, it can be used as a prognostic biomarker in patients with high-risk.
Methods: This is a case-control study. The single nucleotide polymorphism of -1562C>T allele of MMP9 gene promoter was genotyped by hit Tetra ARMS PCR technique in 100 diabetic patients with foot ulcer grade 1 or 2 as the case group according Wagner classification and in 100 diabetic patients without foot ulcer as the control group. Results: The Chi-square test revealed significant difference in genotype frequency of CC, CT and TT alleles of -1562C>T allele of MMP9 gene promoter between case and control groups (P=0.000).
Conclusion: According to this study, there is a relationship between -1562C>T allele of MMP9 gene promoter with diabetic foot ulcer in type2 diabetes patients. Thus we can introduce this biomarker for evaluation of risk and prognosis of diabetic foot ulcers.
Mohammad Azimi Alamouti , Niloufar Shayan, Maryam Momeni, Masoumeh Nouri, Azam Koohkan, Ensiyeh Hajizadeh-Saffar, Fatemeh Soltanolizadeh, Maliheh Mahmoudi, Mahin Jamshidi Makiani, Marzieh Ebrahimi,
Volume 18, Issue 3 (3-2019)
Abstract
Background: For nearly 100 years, amniotic membranes have been used to treat various types of skin wounds. Amniotic extract is one of the derivatives of amniotic membrane that contains all the properties of amniotic membrane. The aim of this study was to evaluate the safety of the amniotic membrane extract in the treatment of diabetic ulcers.
Methods: This study was an Open labeled clinical trial without control group. A total of 10 patients with Wagner Grade 2 diabetic foot ulcers were selected in both sexes. The extract was used every 48 hours in the first week and every 72 hours from the second week until the end of the wound treatment. Patients were followed up weekly until wound healing.
Results: In this study 80% of patients were men and 20% were women with mean age (56.7 ± 8.7) years. The ulcer duration was 8.9 ± 2.12 weeks. The mean area of ulcers at the time of entry into the wound group ≥ 500 mm2, 977.5 ± 201.9 and in the wound group ≤500 mm2 was 145.6 ± 36.4. At 4 weeks post treatment, the wound healing rate in the wound group was ≤500mm2 ,98.9 ± 2.40 % and in the wound group ≥mm2 500 was 92.1 ± 7.23%. in sixth week of treatment, ulcers were complete closure in both groups.
Conclusion: The results of this study suggest that the use of amniotic extract can be effective in the healing of diabetes foot ulcer without any side effects.
Maryam Aalaa, Mohammad Reza Mohajeri-Tehrani, Ghobad Ramezani, Mohammad Reza Amini, Maryam Aboeerad, Mahnaz Sanjari,
Volume 19, Issue 1 (1-2020)
Abstract
Background: Peripheral neuropathy is one of the most common problems in diabetic patients. The increased risk of Diabetic Foot Ulceration (DFU) and amputation would be a complication of diabetic neuropathy. The aim of this study was to compare the DFU healing in different severity classification of neuropathy.
Methods: This is a retrospective study that was conducted over a two-year period from April 2016 to March 2018 according to the information of patients records with Diabetes Mellitus (DM) referred to clinic of diabetes and metabolic disorders of Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences. Wound healing criteria including area, depth and healing duration were studied. Accordingly, changes in the area and depth of wounds were evaluated and reported during the first, third and sixth months after baseline. Data were analyzed using descriptive and inferential statistics using SPSS software version 16.
Results: The results of the study of patients with neuropathic ulcer showed that males and age group of 56 to 65 years had the highest frequencies. In addition, most of these patients suffered from type 2 DM (79%). The rate of wound healing, which was measured by area and depth of wound in three time periods, differed in different severity classification of neuropathy; at mild level of neuropathy the area and depth of wound decreased faster but in severe neuropathy, duration of wound healing in both mentioned criteria has increased. Regarding to the increase in the duration of DM, the healing time increased too. However the rate of wound healing decreased with increased age (p-value = 0.001).
Conclusion: Evidence suggests that early identification of neuropathy can reduce the incidence of DFU and amputation. Due to the slow healing of the size and depth of the wound in diabetic patients with severe neuropathy, it is necessary to prevent DFU by conducting preventive care and educational interventions.
Mahnaz Sanjari, Maryam Aalaa, Mohammadreza Amini, Neda Mehrdad, Mohammadreza Mohajeri,
Volume 19, Issue 3 (2-2020)
Abstract
Background: Diabetic foot is one of the main complications of diabetes, which is caused by a significant proportion of patients with diabetes and which imposes costs on the family and the health system around the world. This review aims to summarize the latest findings in the field of diabetic foot based on clinical guidelines.
Methods: In this review study, in order to achieve the best clinical guide in the field of diabetic foot by determining the search strategy and inclusion criteria, all related clinical guides were searched in the databases and websites of clinical guidelines. Clinical guidelines related to diabetic foot care were searched and retrieved from January 2000 to early 2019 and screened separately by two researchers to select the selected clinical guideline.
Results: Based on the study criteria, the clinical guide of the International Diabetic Foot Working Group was selected as the most complete guide in the field of diabetic foot. This summary is based on the International Working Group on the Diabetic Foot (IWGDF) Guidance 2015, consist of five documents including prevention of foot ulcers in at‐risk patients, footwear and offloading principles, diagnosis, prognosis and management of peripheral artery disease, foot infections in patients with diabetes and enhance healing of chronic ulcers of the foot in diabetes.
Conclusion: This Summary Guidance for Daily Practice is intended to overview of the main aspects of the prevention and treatment of foot problems in patients with diabetes. This summary guidance is adviced at healthcare providers and specialists in foot care throughout the world.
