loading… Can we reverse neuropathy? Probably one of the million dollar questions in diabetic foot research that has been haunting clinicians and researchers for years. Loss of protective sensation is the primary risk factor for diabetic foot ulcers, and no treatment is available to reverse this loss. Electrical stimulation has received some attention in the…

loading… It is widely known that bone density changes in people with diabetes. This may lead to fractures, and is proposed to leave individuals susceptible to Charcot neuroarthropathy. However, bone density cannot be accurately assessed using existing techniques. A new method has been proposed by a group of Australian researchers to measure bone density in…

loading… To gain accurate insight into the costs and cost-effectiveness of diabetic foot ulcer care, studies using decision analytic models are needed. We have discussed two studies modelling recently (here and here). A new study has been published, adding further weight to the discussion on costs and cost-effectiveness. As these modelling studies are relatively complex, and…

loading… Various companies around the world are busy developing smart insoles to prevent foot ulcers. These insoles mainly target plantar pressure measurements, as there is proven clinical benefit in reducing plantar pressure using therapeutic footwear that is being worn (see here and here). As with many medical devices, companies can be quick to point at…

loading… A longstanding debate in the field of diabetic foot infection concerns the best method for microbiology assessment in patients with a suspected foot infection: a wound swab or a tissue sample? A wound swab is relatively easy, cheap, and has fewer adverse events such as bleeding or pain. A tissue sample is more likely…

loading… Advanced biomechanical measurements are finally moving from the laboratory to clinical practice, with the relevance of in-shoe pressure measurements in ulcer prevention described in the most recent International Working Group on the Diabetic Foot (IWGDF) Guidance. These recommendations mainly focus on peak pressure or force, as these can be measured in preventative devices and…

loading… Screening of people with diabetes for complications or their well-known risk factors is an important part of prevention. Unfortunately, it is also one that too often gets neglected or missed, especially in people living in rural and remote areas, far away from general practitioners or other trained healthcare providers. A new study from France…

loading… Offloading is one of the cornerstones of prevention of foot ulcers. The basic idea is easy: when there is no stress on the skin (i.e., when it is adequately offloaded), skin will not break down. Apart from adequate footwear, reducing physical activity seems another method to reduce the stress on someone’s foot. When a…

loading… The majority of care for a patient with a diabetic foot ulcer takes place away from the clinic, in the patient’s own environment. However, it is not easy for clinicians to assess what happens there. It may vary from patient to patient, depending on a large variety of circumstances. One of them concerns a…

loading… Two new articles have been published from two completely different resources, both pointing at the importance of timely vascular assessment in people with diabetes. In people with diabetes, absent pedal pulses are independent predictors of major vascular outcomes, and in people with a foot ulcer revascularisation needs to take place within two weeks to…