diabetic_foot_ulcer_treatment

Diabetic Wound Care

What is a diabetic foot?

As the name suggests diabetic foot is a condition, which develops in people having diabetes. The quantity of sugar or glucose is very high in the blood of the patients suffering from diabetes and this causes nerve damage and poor blood flow, which can lead to serious foot problems. Damage to the blood vessels can also mean that the feet do not get enough blood and oxygen. There is reduced ability to feel pain and thus minor injuries may not be discovered by the patient for a long duration. Under these conditions, if the patient gets a sore or any infection, it is harder to heal. People with diabetes are also at risk of developing a diabetic foot ulcer.Prompt attention to any sore or infection on your toe or foot can prevent gangrene.Where wounds take a long time to heal, infection may set in and lower limb amputation may be necessary. Foot infection is the most common cause of non-traumatic amputation in people with diabetes.

Research estimates that the lifetime incidence of foot ulcers within the diabetic community is around 15% and may become as high as 25%. This is as per the study done and details in the link http://jama.jamanetwork.com/article.aspx?articleid=200119

Common warnings signs of diabetic foot ulcer include:

  • Poor blood flow.
  • High blood sugar (hyperglycemia).
  • Trauma to the foot.
  • Nerve damage.
  • Irritated or wounded feet.

There are so many ways the patient can try and avoid foot problems as given below:

  • Control your blood sugar levels.
  • Maintain good foot hygiene.
  • Check your feet every day for any infection or cut etc.
  • Wash your feet every day and dry them nicely.
  • Keep the skin soft and smooth.
  • Smooth corns and calluses gently with the help of your health provider.
  • Trim your toenails regularly or ask a foot doctor (podiatrist) to trim them for you.
  • Wear shoes and socks at all times.
  • Protect your feet from hot and cold weather.
  • Keep the blood flowing to your feet.

Diabetic foot ulcer can be classified as follows:

  • Ischemic
  • Neuropathic
  • Neuro-ischemic

Prevention and Treatment of Leg and Foot Ulcers

Diabetic foot ulcer is a complex process starting from infection, neuropathy and impaired vascular supply. Neuropatheic ulcers develop due to distal sensory loss and consequent foot deformity. Impaired vascular supply leads to poor blood flow to the wound site, leading to decreased blood supply in the area of infection.Wound healing process involving several cytokines in combination with paracrine factors and cells restoration (fibroblasts, extracellular matrix) is hampered due to diabetes or metabolic disorders.

Mesenchymal Stem cells therapy to prevent diabetic foot ulcer is a cornerstone in the field of cellular based therapies. Mesenchymal stem cells have the capacity to form angiogenesis (tissue regeneration), immunomodulate immune system and activate wound healing function of resident cells. In addition to MSCs, combination of platelet-rich plasma can produce a symbiotic effect in wound healing process.

Procedure For Treating Diabetic Foot Ulcer

Medical intervention includes Intravenous injection (IV) and Intramuscular (IM) injections from Umbilical Cord Mesenchymal Stem Cells.

*This is just a tentative intervention, injection and cell type may change depending upon the patient condition and subject to doctor’s medical review.

Treatment outcome of Diabetic Foot Ulcer

Stem cell intervention can bring significant improvements in healing and decrease in wound size and inflammation and ease of pain. These improvements may vary from patient to patient and cannot be guaranteed.

References

http://www.intechopen.com/books/stem-cells-in-clinic-and-research/topical-stem-and-progenitor-cell-therapy-for-diabetic-foot-ulcers

**Use of Stem cells is in evolution phase and categorized non-conventional**