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Diabetic Foot

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Common foot problems in persons with DIABETES MELLITUS, caused by any combination of factors such as DIABETIC NEUROPATHIES; PERIPHERAL VASCULAR DISEASES; and INFECTION. With the loss of sensation and poor circulation, injuries and infections often lead to severe foot ulceration, GANGRENE and AMPUTATION.

Also Known As:

Diabetic Feet; Feet, Diabetic; Foot, Diabetic; Foot Ulcer, Diabetic

Networked: 1851 relevant articles (164 outcomes, 336 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Ulcer
2.	Wounds and Injuries (Trauma)
3.	Infection
4.	Osteomyelitis
5.	Diabetes Mellitus

Experts

1.	Armstrong, David G: 48 articles (05/2015 - 04/2002)
2.	Lipsky, Benjamin A: 28 articles (11/2015 - 05/2004)
3.	Boulton, Andrew J M: 22 articles (09/2013 - 04/2002)
4.	Lavery, Lawrence A: 19 articles (03/2014 - 04/2002)
5.	Nather, Aziz: 13 articles (01/2015 - 03/2008)
6.	Aragón-Sánchez, Javier: 11 articles (11/2015 - 03/2010)
7.	Edmonds, Michael: 10 articles (05/2015 - 01/2006)
8.	Veves, Aristidis: 10 articles (05/2015 - 03/2002)
9.	Zgonis, Thomas: 10 articles (10/2012 - 07/2007)
10.	Kirsner, Robert S: 9 articles (09/2015 - 01/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Diabetic Foot:

1.	platelet-derived growth factor BB (becaplermin)FDA Link 03/01/2010 - "Previous topical growth factor studies have shown that recombinant human platelet-derived growth factor-BB isomer (rhPDGF-BB) is an efficacious treatment of chronic diabetic foot ulceration. " 06/01/2005 - "Although the sample size was not large enough to demonstrate that the incidence of healing in the OASIS group was statistically superior (P = .055), the study results showed that treatment with OASIS is as effective as Regranex in healing full-thickness diabetic foot ulcers by 12 weeks." 10/01/2002 - "Results of this analysis suggest that becaplermin may ultimately be more cost-effective for the treatment of chronic diabetic foot ulcers than other treatment modalities, despite its higher initial dollar cost. " 01/01/2001 - "Becaplermin may be a cost-effective treatment for neuropathic diabetic foot ulcers in a wide range of European settings. " 01/01/2003 - "The DFS-SF was created through the analysis of data from a double-blind, placebo-controlled, randomised trial of the efficacy and safety of becaplermin (recombinant human platelet-derived growth factor BB) in the treatment of chronic, full-thickness, neuropathic, diabetic foot ulcers. "
2.	Anti-Bacterial Agents (Antibiotics)IBA 05/01/2008 - "The aim of this paper is to review evidence for the efficacy of new antibiotics in the management of SSSIs, including any data relating specifically to the diabetic foot, and to consider where they might fit into the therapeutic armory against DFI." 12/01/2012 - "A severely infected diabetic foot treated successfully without using systemic antibiotics." 01/01/2011 - "The purpose of the research work is to call attention to a frightening twist in the antibiotic-resistant Enterococci problem in diabetic foot that has not received adequate attention from the medical fraternity and also the pharmaceutical pipeline for new antibiotics is drying up. " 04/01/2008 - "A prospective study was carried out on patients with diabetic foot lesions to determine their clinical characteristics, the spectrum of aerobic microbial flora and to assess their comparative in vitro susceptibility to the commonly used antibiotics. " 05/01/2005 - "The effect of different antibiotics on the outcome of surgical care in the management of diabetic foot was investigated. "
3.	OxygenIBA 05/01/2014 - "After 3 months TcPO2 studies revealed statistically significant higher oxygen tissue pressure in diabetic feet covered by Integra® plus STSG. " 10/01/2013 - "More clinical studies have to be conducted to evaluate therapeutical methods that might ameliorate cutaneous oxygen saturation within diabetic foot disease and PAOD." 01/01/2011 - "This study included 29 ischemic diabetic feet, as determined by a transcutaneous oxygen pressure (TcPO(2) )<30 mmHg. " 12/01/2014 - "Role of comorbidities as limiting factors to the effect of hyperbaric oxygen in diabetic foot patients: a retrospective analysis." 11/01/2014 - "Transcutaneous partial oxygen tension (TcPO₂) values of diabetic feet were measured before, during, and after NBO therapy. "
4.	SilverIBA 01/01/2010 - "Only one comparison showed a significant reduction in healing time associated with a silver-containing hydrofibre dressing in diabetic foot ulcers. " 10/01/2015 - "With the results of the study, it was concluded that VAC GranuFoam silver dressing can be superior to conventional GranuFoam dressing in reducing the recurrence rate of infected diabetic foot ulcers." 01/01/2015 - "The aim of this paper is to examine the evidence on the use of nanocrystalline silver and manuka honey for treating diabetic foot ulcers through a critical and comprehensive review of in vitro studies, animal studies, and in vivo studies. " 03/01/2008 - "This in vitro study was conducted to assess the prevalence of silver resistance genes in 112 bacterial isolates obtained from the diabetic foot ulcers of patients attending the Diabetic Foot Clinic at Tameside General Hospital, UK. " 01/01/2006 - "No studies were identified that met with the inclusion criteria Despite the widespread use of dressings and topical agents containing silver for the treatment of diabetic foot ulcers, no randomised trials or controlled clinical trials exist that evaluate their clinical effectiveness. "
5.	Epidermal Growth Factor (EGF)IBA 07/01/2014 - "Efficacy of intralesional recombinant human epidermal growth factor in diabetic foot ulcers in Mexican patients: a randomized double-blinded controlled trial." 04/01/2015 - "Efficacy of intralesional recombinant human epidermal growth factor in chronic diabetic foot ulcers." 07/01/2014 - "Efficacy of topical application of beta urogastrone (recombinant human epidermal growth factor) in Wagner's Grade 1 and 2 diabetic foot ulcers: Comparative analysis of 50 patients." 01/01/2015 - "Thus, this preliminary study suggests that EGF seems to be a potential adjunctive treatment option in patients with limb-threatening diabetic foot wounds." 01/01/2013 - "After several exploratory and confirmatory clinical trials, the intralesional administration of human recombinant epidermal growth factor (hrEGF) has been approved for the treatment of advanced diabetic foot ulcers (DFU). "
6.	Platelet-Derived Growth FactorIBA 04/01/2009 - "Analysis of patient cost for recombinant human platelet-derived growth factor therapy as the first-line treatment of the insured patient with a diabetic foot ulcer." 11/01/2009 - "Treatment of nonhealing diabetic foot ulcers with a platelet-derived growth factor gene-activated matrix (GAM501): results of a phase 1/2 trial." 04/01/2015 - "Topical platelet derived growth factor does not appear to significantly improve healing of Wagner grade I diabetic foot ulcers that are treated by offloading with a short leg walking cast. " 04/01/2015 - "Topical platelet-derived growth factor vs placebo therapy of diabetic foot ulcers offloaded with windowed casts: a randomized, controlled trial." 01/25/2013 - "THIS STUDY AIMS TO COMPARE THE EFFICACY OF ANTISEPTIC DRESSINGS, HYPERBARIC OXYGEN THERAPY, AND RECOMBINANT HUMAN PLATELET DERIVED GROWTH FACTOR (RHPDGF) FOR TWO REASONS: i) to reduce the incidence of lower limb amputations in diabetic foot ulcer; ii) to limit the duration of stay in the hospital. "
7.	Phenytoin (Dilantin)FDA LinkGeneric 01/01/2009 - "The impact of topical phenytoin on recalcitrant neuropathic diabetic foot ulceration." 01/01/2009 - "Topical phenytoin significantly improved healing of recalcitrant neuropathic diabetic foot ulcers. " 10/01/1991 - "The efficacy of topical phenytoin in the treatment of diabetic foot ulcers was evaluated in a controlled inpatient study. " 03/01/2004 - "Phenytoin efficacy in treating the diabetic foot ulcer of a haemodialysis patient." 10/01/2013 - "A randomized control study was conducted to evaluate the effect of topical phenytoin on healing in diabetic foot ulcers. "
8.	HydrogelIBA 11/01/2015 - "In the clinical study, 17 individuals with mildly inflamed diabetic foot ulcers were randomized to receive CC ointment (CCO) or hydrogel. " 01/01/2013 - "Hydrogel dressings for healing diabetic foot ulcers." 01/01/2011 - "Hydrogel dressings for healing diabetic foot ulcers." 01/01/2002 - "There is evidence to suggest that hydrogel increases the healing rate of diabetic foot ulcers. " 01/01/2010 - "There is evidence to suggest that hydrogel increases the healing rate of diabetic foot ulcers compared with gauze dressings or standard care and larval therapy resulted in significantly greater reduction in wound area than hydrogel. "
9.	Glucose (Dextrose)FDA LinkGeneric 04/01/2015 - "This paper is based on the initial findings from a prospective ongoing study to evaluate the efficacy of flourodeoxy glucose positron emission tomography-computed tomography (FDG-PET CT) in diabetic foot evaluation. " 04/01/2015 - "18-F flourodeoxy glucose positron emission tomography-computed tomography imaging: A viable alternative to three phase bone scan in evaluating diabetic foot complications?" 08/01/2006 - "Poor glucose control in the year before admission as a powerful predictor of amputation in hospitalized patients with diabetic foot ulceration." 01/03/2007 - "In conclusion, the anti-diabetic foot ulcer Formula 1 contains ingredients active in modifying tissue glucose homeostasis in vitro but these biological activities could not be associated with improved glycaemic control of diabetes in vivo." 10/01/2012 - "The effect of the herbal extracts/natural compounds on the growth of keratinocytes was not influenced by a high glucose level, a condition similar to diabetic patients who usually suffer from diabetic foot ulcers. "
10.	Granulocyte Colony-Stimulating Factor (G-CSF)IBA 02/01/2014 - "Based on these preclinical studies, we performed a prospective clinical trial phase I/IIa study of autologous G-CSF-mobilized peripheral blood (PB) CD34(+) cell transplantation for nonhealing diabetic foot patients. " 01/01/2013 - "Randomised controlled trials (RCTs) that evaluated the effect of adding G-CSF to usual care in people with a diabetic foot infection. " 01/01/2009 - "Randomised controlled trials (RCTs) that evaluated the effect of adding G-CSF to usual care in people with a diabetic foot infection. " 02/01/2005 - "We systematically searched the medical literature (including Medline, Embase, LookSmart, and the Cochrane Library) for prospective randomized studies that used G-CSF as an adjunct to standard treatment for diabetic foot infections. " 12/01/2004 - "Three clinical trials evaluating G-CSF for diabetic foot infections were identified. "

Therapies and Procedures

1.	Amputation 11/01/1998 - "The study concluded that multidisciplinary diabetes care team, which includes aggressive foot care and consistent treatment-based risk classification, may be effective in profoundly mitigating the occurrence and recurrence of diabetic foot sequelae, including ulceration and amputation. " 09/01/2010 - "Although the team approach to diabetic foot problems is effective in preventing lower-extremity amputations, the costs associated with implementing a diabetic-foot-care team are not well understood. " 09/01/2010 - "Although the team approach to diabetic foot problems is effective in preventing lower extremity amputations, the costs associated with implementing a diabetic foot care team are not well understood. " 09/01/1998 - "This is thought to be achievable because both primary and secondary preventative healthcare strategies are effective in reducing the incidence of diabetic foot ulceration and progression to amputation. " 01/01/2015 - "The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country."
2.	Debridement 07/01/2014 - "Careful patient selection, skillful assessment of debridement margins and meticulous technique are required and may be offered by experienced designated surgeons in a specialized diabetic foot unit." 09/01/2012 - "Rational debridement is the key prerequisite for healing of sinus tract in diabetic foot." 09/01/2012 - "Role of early radical debridement and skin cover in diabetic foot ulceration." 06/01/2010 - "From January to December 2008, 393 patients underwent surgical treatment for diabetic foot syndrome; 30 patients underwent immediate surgical debridement resulting in exposed tendon and/or bone tissues. " 06/01/2002 - "Debridement of the diabetic foot: a podiatric perspective."
3.	Negative-Pressure Wound Therapy 10/01/2009 - "The purpose of this study was to present the experience of the use of vacuum assisted closure (VAC) in the treatment of advanced and complicated diabetic foot lesions. " 03/01/2006 - "Managing the diabetic foot with the use of vacuum-assisted closure: a call for more studies." 01/01/2014 - "[The use of negative pressure wound therapy in patients with infectious surgical complications of diabetic foot]." 09/01/2013 - "Negative pressure wound therapy and other new therapies for diabetic foot ulceration: the current state of play." 02/01/2013 - "Use of indigenously made negative-pressure wound therapy system for patients with diabetic foot."
4.	Hyperbaric Oxygenation 01/01/2012 - "The use of hyperbaric oxygen therapy in the treatment of infected diabetic foot is controversial because studies in this area are few and methodologically questionable. " 06/01/2010 - "This study was performed to evaluate the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of the infected diabetic foot. " 07/01/1992 - "To study the effect of hyperbaric oxygen therapy in chronic diabetic foot lesions, a prospective controlled study was undertaken. " 06/01/2014 - "Treatment of diabetic foot complications with hyperbaric oxygen therapy: a retrospective experience." 07/15/2006 - "Hyperbaric oxygen therapy consumes very substantial resources--and has the potential to consume far more--that could be better spent on other aspects of management or prevention of diabetic foot ulceration. "
5.	Limb Salvage 01/01/2014 - "This study evaluated the factors predictive of the success of limb salvage surgery and identified indicators for preserving as much as possible of the leg of a patient with diabetic foot. " 02/01/2008 - "Limb salvage in extensive diabetic foot ulceration: an extended study using a herbal supplement." 01/01/2015 - "Its effect on limb salvage in the management of the diabetic foot is well described in the literature. " 11/01/2014 - "Hence, guidelines need to be reinforced to prevent diabetic foot complications and to achieve limb salvage if complications are unpreventable." 01/01/2014 - "Our case-based review focuses on limb salvage through operative management of Charcot neuroarthropathy of the diabetic foot. "