July 9, 2019
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Diagnosis and Management of Diabetic Foot Ulcers

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In The News
Diabetic Foot Ulcer Outcomes Improve With Better Access, More Comprehensive Care
Fewer first-time diabetic foot ulcers were reported from 2013 to 2017 compared with 2003 to 2007 in a high-risk population that had access to more comprehensive podiatry care services, according to findings published in Diabetic Medicine. “Persons living with diabetes and loss of protective foot sensation, foot deformity and/or peripheral vascular disease are at high risk of diabetic foot ulceration, and those with previous ulceration are at even greater risk,” Richard B. Paisey, MD, of the Torbay and South Devon Integrated Care Trust in the United Kingdom, and colleagues wrote. “Attempts to reduce new and recurrent ulceration in high-risk persons have required intensive intervention and follow-up.”

Inpatient Hypoglycemia Predicts Major Amputation in Diabetic Foot Disease
Patients hospitalized with acute diabetic foot are more likely to undergo any or major amputations when experiencing a hypoglycemic event, independent of other amputation risk factors, according to an analysis of electronic medical records data. “This study is the first to assess the impact of glycemic control on patients with acute diabetic foot in the inpatient setting,” Avivit Cahn, MD, a senior physician at Hadassah Hebrew University Medical Center in Jerusalem, told Endocrine Today. “The study found an important association between inpatient glycemic control and amputations, with a stronger association of hypo- rather than hyperglycemia with adverse outcomes.”
US Study Finds Racial Disparities in Outcomes of Superficial Vein Treatments
A US-based multicentre study has found that while chronic venous insufficiency is “primarily observed in white women”, there are other notable differences in the incidence and prevalence of disease severity and outcomes when comparing patients’ racial groups, with African Americans requiring a higher number of superficial vein treatments to achieve good results. Peter J Pappas (Center for Vein Restoration, Greenbelt, USA) presented the findings at the European Venous Forum (EVF; 27–29 June) in Zurich, Switzerland.

Combining Antibiotics, Researchers Deliver One-Two Punch against Ubiquitous Bacterium
By combining two well-established antibiotics for the first time, a scientific team led by Case Western Reserve University School of Medicine and Louis Stokes Cleveland VA Medical Center has delivered a “double whammy” against the pervasive Pseudomonas aeruginosa, a potentially deadly form of bacteria that is a major source of hospital-based infections. In a recent Journal of Infectious Diseases study, investigators showed using two antibiotic drugs to fight P. aeruginosa in mouse models was significantly more effective than either antibiotic alone. The antibiotics were ceftazidime-avibactam, a combination drug used to treat a wide variety of serious bacterial infections, and fosfomycin, used to primarily treat infections of the urinary tract.

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