Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)
Published: Dec. 18, 2024
Abstract Diabetes-related foot ulceration (DFU), a serious but preventable complication of diabetes, is leading cause hospitalisation, lower extremity amputation and disability worldwide. People with DFU have greater burden cardiovascular risk factors, heart failure chronic kidney disease, resulting in over two-fold higher death compared people diabetes without DFU. Here, we propose “cardio-renal-metabolic-foot” connection based on shared pathophysiological mechanisms linking renal disease. Whilst these mechanistic links remain to be fully elucidated, systemic inflammation infection the context are postulated as key mediators development, progression of, However, disease also implicated pathogenesis DFU, highlighting multi-directional interplay between conditions. The impact screening, prevention, early management complications associated requires further research. Multi-modality cardiac imaging could play role unravelling novel therapeutic strategies, well facilitating personalised assessment management. Recent clinical trials transformed landscape for type 2 by demonstrating that sodium glucose co-transporter inhibitors, glucagon-like peptide-1 agonists non-steroidal mineralocorticoid receptor antagonists improve outcomes. Although dedicated research warranted, therapies target multiple facets connection. holistic, person-centred approach managing should incorporate new multidisciplinary models care focusing prevention Graphical abstract cardio-renal-metabolic-foot diabetes. There critical need (1) better understanding connecting perhaps guided imaging, biomarkers, multi-omics artificial intelligence facilitate current treatments development (2) more data from trials, registries biobanks inform guidelines evidence-based medicine, (3) health system-wide integration structured contemporary emphasis patient diabetes-related ulceration. Created BioRender.com
Language: Английский