Un parcours de soins primaires pour améliorer la prise en charge et le pronostic des patients diabétiques avec une plaie de pied

Resume Introduction Les plaies de pied diabetique (PPD) sont un probleme frequent, associe a un risque eleve d’amputation et de mortalite. L’adressage rapide a une structure specialisee du pied diabetique permet d’ameliorer le taux de cicatrisation et de diminuer le risque d’amputation. Une proportion importante de patients avec une PPD sont adresses tardivement vers ces structures specialisees. Un parcours de soins primaires des patients avec une PPD a ete developpe par l’International Diabetic Foot Care Group en collaboration avec le D-Foot International pour ameliorer l’orientation de ces patients vers les structures specialisees. Nous presentons une version adaptee au systeme de soin fr…

Improving referral of patients with diabetic foot ulcer to specialised diabetes foot care units.

Benfotiamine accelerates the healing of ischaemic diabetic limbs in mice through protein kinase B/Akt-mediated potentiation of angiogenesis and inhibition of apoptosis.

Benfotiamine, a vitamin B1 analogue, reportedly prevents diabetic microangiopathy. The aim of this study was to evaluate whether benfotiamine is of benefit in reparative neovascularisation using a type I diabetes model of hindlimb ischaemia. We also investigated the involvement of protein kinase B (PKB)/Akt in the therapeutic effects of benfotiamine. Streptozotocin-induced diabetic mice, given oral benfotiamine or vehicle, were subjected to unilateral limb ischaemia. Reparative neovascularisation was analysed by histology. The expression of Nos3 and Casp3 was evaluated by real-time PCR, and the activation state of PKB/Akt was assessed by western blot analysis and immunohistochemistry. The f…

Characteristics of new patient referrals to specialised diabetic foot units across Europe and factors influencing delays

Objective: Foot ulcers are a common complication of diabetes and are associated with an increase in lower limb amputation and death. Early referral to a specialised unit is recommended. The aim of this study was to assess the characteristics of new-patient referrals to specialised diabetes foot care units across Europe and to determine the factors involved in delayed referral. Method: In this prospective observational study, consecutive patients with a new foot ulcer presenting to nine diabetic foot centres in five European countries (France, Germany, Italy, Spain and the UK) were included. Results: Some 25% of the 332 patients included had presented with a foot ulcer >3 months before re…