Diabetic foot secondary prevention

Jump to navigation Jump to search

Diabetic foot Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Diabetic foot from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Diabetic foot secondary prevention On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Diabetic foot secondary prevention

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Diabetic foot secondary prevention

CDC on Diabetic foot secondary prevention

Diabetic foot secondary prevention in the news

Blogs on Diabetic foot secondary prevention

Directions to Hospitals Treating Diabetic foot

Risk calculators and risk factors for Diabetic foot secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2] Usama Talib, BSc, MD [3]

Overview

For an appropriate secondary prevention, physicians should focus on strategies such as pressure offloading, use of appropriate footwear (such as pressure-relieving footwear), treatment of existing infection and debridement. Early amputation and reconstruction of the damaged vessels could also assist faster wound healing and will prevent further destruction.

Secondary Prevention

The secondary prevention of diabetic foot ulcer includes the following along with the use of primary preventive strategies:[1][2][3][4]

Clinical Trials


Randomized controlled trials of interventions for secondary prevention of complications of diabetic foot[7][5][8].
Trial Patients Intervention Comparison Outcome Results Comment
Intervention Control
Uccioli[7]
1995
69 patients
• Prior ulceration
Therapeutic shoes Usual footwear Re-ulceration 28% 58% Significant difference
Reiber[5]
2002
400 patients
• Prior ulceration
• Excluded severe deformity
Therapeutic shoes Usual footwear Re-ulceration 15% 17% Insignificant difference
Lincoln[8]
2008
172 patients
• Prior ulceration
• Specialist clinic
Targeted, one-to-one education Usual care Re-ulceration at
• 6 months
• 1 year
• 30%
• 41%
• 21%
• 41%
• Insignificant
• Insignificant

References

  1. Armstrong DG, Boulton AJM, Bus SA (2017). "Diabetic Foot Ulcers and Their Recurrence". N Engl J Med. 376 (24): 2367–2375. doi:10.1056/NEJMra1615439. PMID 28614678.
  2. Frykberg RG, Armstrong DG, Giurini J, Edwards A, Kravette M, Kravitz S; et al. (2000). "Diabetic foot disorders: a clinical practice guideline. American College of Foot and Ankle Surgeons". J Foot Ankle Surg. 39 (5 Suppl): S1–60. PMID 11280471.
  3. Cavanagh PR, Ulbrecht JS, Caputo GM (2000). "New developments in the biomechanics of the diabetic foot". Diabetes Metab Res Rev. 16 Suppl 1: S6–S10. doi:10.1002/1520-7560(200009/10)16:1+<::aid-dmrr130>3.0.co;2-z. PMID 11054880.
  4. Hartsell HD, Fellner C, Saltzman CL (2001). "Pneumatic bracing and total contact casting have equivocal effects on plantar pressure relief". Foot Ankle Int. 22 (6): 502–6. doi:10.1177/107110070102200609. PMID 11475459.
  5. 5.0 5.1 5.2 Reiber GE, Smith DG, Wallace C, Sullivan K, Hayes S, Vath C; et al. (2002). "Effect of therapeutic footwear on foot reulceration in patients with diabetes: a randomized controlled trial". JAMA. 287 (19): 2552–8. PMID 12020336.
  6. Uccioli L, Faglia E, Monticone G, Favales F, Durola L, Aldeghi A, Quarantiello A, Calia P, Menzinger G (1995). "Manufactured shoes in the prevention of diabetic foot ulcers". Diabetes Care. 18 (10): 1376–8. PMID 8721941.
  7. 7.0 7.1 Uccioli L, Faglia E, Monticone G, Favales F, Durola L, Aldeghi A; et al. (1995). "Manufactured shoes in the prevention of diabetic foot ulcers". Diabetes Care. 18 (10): 1376–8. doi:10.2337/diacare.18.10.1376. PMID 8721941.
  8. 8.0 8.1 Lincoln NB, Radford KA, Game FL, Jeffcoate WJ (2008). "Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial". Diabetologia. 51 (11): 1954–61. doi:10.1007/s00125-008-1110-0. PMID 18758747.