Risk factors and a predictive model of diabetic foot in hospitalized patients with type 2 diabetes

World Journal of Diabetes, Journal Year: 2025, Volume and Issue: 16(3)

Published: Jan. 20, 2025

BACKGROUND The risk factors and prediction models for diabetic foot (DF) remain incompletely understood, with several potential still requiring in-depth investigations. AIM To identify new-onset DF develop a robust model hospitalized patients type 2 diabetes. METHODS We included 6301 diabetes from January 2016 to December 2021. A univariate Cox least absolute shrinkage selection operator analyses were applied select the appropriate predictors. Nonlinear associations between continuous variables of explored using restricted cubic spline functions. was further employed evaluate impact on DF. area under curve (AUC) measured accuracy model. RESULTS Seventy-five inpatients experienced incidence density 4.5/1000 person-years. long duration diabetes, lower extremity arterial disease, serum albumin, fasting plasma glucose (FPG), nephropathy independently associated Among these factors, albumin concentration inversely DF, hazard ratio (HR) 95% confidence interval (CI) 0.91 (0.88-0.95) (P < 0.001). Additionally, U -shaped nonlinear relationship observed FPG level After adjusting other variables, HRs 95%CI 4.4 mmol/L ≥ 7.0 3.99 (1.55-10.25) = 0.004) 3.12 (1.66-5.87) 0.001), respectively, which greater than mid-range (4.4-6.9 mmol/L). AUC predicting over 3 years 0.797. CONCLUSION demonstrated Serum levels negatively nomogram showed good discrimination ability duration, FPG, (Clinicaltrial.gov NCT05519163).

Language: Английский

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Immortalized Schwann cell lines as useful tools for pathogenesis-based therapeutic approaches to diabetic peripheral neuropathy

Frontiers in Endocrinology, Journal Year: 2025, Volume and Issue: 15

Published: Jan. 21, 2025

Growing evidence suggests that hyperglycemia-related abnormalities in Schwann cells play a pivotal role the development and progression of diabetic peripheral neuropathy (DPN). Several immortalized cell lines have been established our laboratory utilized for study DPN; IMS32 from normal ICR mice, 1970C3 C57BL/6 IWARS1 IKARS1 wild-type aldose reductase-deficient IFRS1 Fischer 344 rats. These retain biological features display high proliferative activities enable us to perform molecular biochemical analyses. In addition, these exhibited metabolic alterations under exposure diabetes-associated conditions, such as hyperglycemia, dyslipidemia, glycative oxidative stress load. Herein, recent studies with regarding pathogenic factors DPN (augmentation polyol other collateral glycolysis pathways, stress-induced injury, autophagic proteostatic disturbances, etc.) therapeutic strategies targeting are introduced.

Language: Английский

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Physiological mechanisms of neuromuscular impairment in diabetes‐related complications: Can physical exercise help prevent it?

The Journal of Physiology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 3, 2025

Diabetes mellitus is a chronic disorder that progressively induces complications, compromising daily independence. Among these, diabetic neuropathy particularly prevalent and contributes to substantial neuromuscular impairments in both types 1 2 diabetes. This condition leads structural damage affecting the central peripheral nervous systems, resulting significant decline sensorimotor functions. Alongside neuropathy, myopathy also muscle impairment reduced motor performance, intensifying decline. Diabetic typically implicates neurogenic atrophy, motoneuron loss clustering of fibres as result aberrant denervation-reinervation processes. These complications are associated with compromised junctions, where alterations occur pre-synaptic vesicles, mitochondrial content post-synaptic signalling. Neural intensified by hyperglycaemia oxidative stress, exacerbating vascular dysfunction reducing oxygen delivery. imply severe evidenced reductions maximal force power output, rate development endurance. Furthermore, diabetes-related compounded age-related degenerative changes long-term patients. Aerobic resistance training offer promising approaches for managing blood glucose levels function. exercise promotes biogenesis angiogenesis, supporting metabolic cardiovascular health. Resistance primarily enhances neural plasticity, strength hypertrophy, which crucial factors mitigating sarcopenia preserving functional topical review examines current evidence on physiological mechanisms underlying potential impact physical activity counteracting this

Language: Английский

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Fast Analgesic Effect in Response Test with Topical Phenytoin Cream Correlates with Prolonged Pain Relief After Extended Use in Painful Diabetic Neuropathy

Pharmaceuticals, Journal Year: 2025, Volume and Issue: 18(2), P. 228 - 228

Published: Feb. 7, 2025

Background: Treatment of painful diabetic neuropathy (PDN) poses several challenges due to the limited effectiveness, high incidence side effects, and potential drug interactions oral neuropathic pain medication. Lacking systemic topical phenytoin cream offers a promising innovative approach addressing unmet needs in treatment. In this retrospective study patients with PDN, we evaluated analgesic effect response tests after extended use. Methods: We collected data from PDN who, prior prolonged use 10% or 20% cream, either had an open test (ORET), single-blind (SIBRET), double-blind (DOBRET) placebo-controlled between November 2016 February 2023. A positive ORET was defined as reduction at least two points on 11-point numerical scale (NRS) within 30 min application. SIBRET DOBRET required additional 1 NRS point treated area compared placebo. test, sustained proportion experiencing minimum relief 30% (MPR30: moderate relief) 50% (MPR50: considerable cream. also assessed correlation relief. Results: identified 65 whom 31 (47.7%) test. The median 3.0 (IQR 2.0-4.0). Extended (median 3.3 months, IQR 1.5-12.1]) resulted 4.0 3.0-5.0); 26/31 (83.9%) achieved MPR30, 21/31 (67.7%) MPR50 correlated significantly (τ = 0.72, p < 0.0001). Conclusions: who provided significant

Language: Английский

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The Role of Inflammation in the Pathogenesis of Diabetic Peripheral Neuropathy: New Lessons from Experimental Studies and Clinical Implications

Diabetes Therapy, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 10, 2025

Language: Английский

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Experimentally induced pain and paresthesia respond differently to parameter changes of cuff-based compression in pain-free young individuals

Journal of Pain, Journal Year: 2025, Volume and Issue: unknown, P. 105339 - 105339

Published: Feb. 1, 2025

Language: Английский

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Assessment of the diabetic foot in inpatients

British Journal of Nursing, Journal Year: 2025, Volume and Issue: 34(4), P. S12 - S23

Published: Feb. 19, 2025

Diabetic foot disease is a severe complication of diabetes, leading to significant morbidity and lower limb amputations. This review explores the pathophysiology diabetic disease, highlighting roles peripheral neuropathy, arterial immunosuppression in development ulcers infections. Key intrinsic extrinsic risk factors, including long-standing poor glycaemic control, inappropriate footwear trauma are discussed. The importance comprehensive assessments using diagnostic tools such as Ipswich Touch Test Doppler studies emphasised for early detection management. Challenges delays referral specialist care, limited access multidisciplinary teams, staffing shortages identified critical barriers effective care. builds upon extant literature by integrating most recent evidence, 2023 guidelines from International Working Group on Foot. It emphasises practical application, detailed pathways care strategies, offering updated insights improve clinical outcomes address often overlooked aspects within inpatient services. Future directions encompass advances imaging, telemedicine patient education, which may further optimise preventive therapeutic strategies disease.

Language: Английский

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Prevalence and concomitance of diabetic peripheral sensory neuropathy and lower limb peripheral arterial disease in type II diabetics and its correlation with obesity

Journal of Family Medicine and Primary Care, Journal Year: 2025, Volume and Issue: 14(2), P. 687 - 692

Published: Feb. 1, 2025

Among type 2 diabetics (T2D), macrovascular complication lower limb Peripheral Arterial Disease (PAD) and microvascular Diabetic Sensory Neuropathy (DPSN) have scarcely studied concordance their association with obesity. Qualitative general body fat parameters give a complete picture of We the vibration perception threshold (VPT)-based DSPN ankle brachial pressure index (ABPI))-based PAD, effect obesity on them, in T2Ds. A cross-sectional study was done 152 under-treatment Bio-esthesiometer-based VPT from sole each foot VersaDop-based ABPI all limbs were assessed. Prevalence (VPT ≥25) PAD (ABPI ≤0.9) measured compared for concomitance. The odds ratio used testing multiple linear regressions accomplished predictors taking P value < 0.05 as statistically significant. T2Ds had mean age 53 years, duration 67 months, 48% glycemic control. prevalence abnormal 64% 23%, respectively. VPT-based subgroups do not defer significantly vice versa. Obesity associated only (visceral > general). Odd's neuropathy vasculopathy insignificant while differences significant predictors. having 23% one-third concomitance but lack different each. Vasculopathy obesity; visceral more than general; suggesting scope its rectification. It suggests progression these complications, despite some cross-talk between them.

Language: Английский

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N-acetyl-L-cysteine Mitigates Diabetes-induced Impairments in Sciatic Nerve

IBRO Neuroscience Reports, Journal Year: 2025, Volume and Issue: 18, P. 512 - 519

Published: Feb. 21, 2025

Diabetic neuropathy is a consequence of long-term hyperglycemia. The emergence neuronal condition result hyperglycemia-induced oxidative stress. In the present study, streptozotocin-induced diabetes exhibited notable decrease in levels phospholipids, glycolipids, gangliosides, and triglycerides sciatic nerve. alterations lipids resulted increase cholesterol to phospholipid ratio nerve diabetic animals. This crucial determines rheological properties membranes substantial reduction activity membrane-bound enzymes; Ca2 + ATPase acetylcholinesterase. Histological examination cross-section mice revealed axonal atrophy disarrayed myelin sheath. potential therapeutic impact N-acetyl Cysteine (NAC), powerful antioxidant, on rat model was evaluated. NAC administered rats drinking water for period 8 weeks. results indicate that administration restored lipid composition; membrane linked enzymes, improved structural defects plays protective role against diabetes-induced composition leading improvement structure function membranes. Overall, findings suggest as strategy preventing other complications.

Language: Английский

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Comprehensive Assessment of Neuropathy and Metabolic Parameters in Type 1 Diabetic Patients with or Without Using Continuous Glucose Sensors

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(5), P. 2062 - 2062

Published: Feb. 26, 2025

The present study was conducted in type 1 diabetic (T1DM) patients to evaluate the metabolic and glycemic control as well manifestations of neuropathy. impact continuous glucose monitoring (CGM) on measured parameters also analyzed. A total 61 T1DM (age: 42.5 ± 1.8 years, DM duration: 22.8 1.6 mean SE) participated study. In total, 24 had CGM sensors 37 did not. Cardiovascular autonomic neuropathy assessed using cardiovascular reflex tests. Peripheral sensory function evaluated by a Neurometer calibrated tuning fork upper lower limbs. Metabolic status characterized determination triglycerides, high-density lipoprotein (HDL), low-density (LDL), cholesterol, glycated haemoglobin (HbA1c). positive correlation found between HbA1c triglyceride levels (r = 0.28, p < 0.05). users non-users differed (0.9 0.1 vs. 1.24 0.12 mmol/L, 0.05), HDL cholesterol (1.7 1.4 0.05 mmol/L), (7.5 0.2 8.3 0.3%, 0.05) well. Significant differences were for Valsalva ratio, Neurometer, results non-users. This significant T1DM. use resulted improved less nerve damage. As novel finding, is presumed prevent both micro-, macrovascular complications and, this way, potentially reducing mortality rates.

Language: Английский

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