Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Research helps identify precursors to foot disease in diabetes patients

14.11.2005


Foot ulcerations are one of the most serious complications of diabetes, resulting in more than 80,000 lower-leg amputations each year in the U.S. alone. A new study led by researchers at the Joslin-Beth Israel Deaconess Foot Center and Microcirculation Laboratory finds that early changes in the oxygenation of the skin could help foretell the development of ulcerations and enable doctors to treat patients at an earlier stage, before the onset of serious complications.



Reported in the Nov. 12 issue of the medical journal The Lancet, the study is part of a special issue devoted to diabetic foot disease to coincide with World Diabetes Day, also Nov.12th.

"Nearly one in 40 diabetes patients will develop foot ulcers every year and more than 15 percent of these individuals will have to undergo amputation," explains Aristidis Veves, MD, DSc, research director of the Joslin-Beth Israel Deaconess Foot Center and Microcirculation Laboratory and associate professor of surgery at Harvard Medical School. "And, unfortunately, an amputation is often the beginning of a rapid downward cycle from which the patient never recovers."


The root of the problem is often a condition known as peripheral neuropathy, which develops when uncontrolled high blood sugar damages the nerves of the legs and feet, resulting in greatly decreased sensitivity.

"Peripheral neuropathy causes extreme numbness and a loss of protective sensation," explains Veves. "As a result, even a minor foot injury [such as a corn or callus, a splinter, or pressure from an improperly fitting shoe] can go undetected by the patient until it has escalated into a chronic wound that won’t heal." Once an ulcer has become infected it can lead to the onset of gangrene, and in the most serious cases, to amputation of the limb.

Knowing that changes in large vessels and the microcirculation of the diabetic foot play a central role in the development of ulcers and their subsequent failure to heal, the authors set out to specifically identify what these changes are.

Using a novel technology known as medical hyperspectral imaging (MHSI), Veves and his colleagues studied a total of 108 patients – 21 control subjects who did not have diabetes, 36 diabetes patients who did not have neuropathy and 51 patients with both diabetes and neuropathy. They also measured foot muscle energy reserves using a magnetic spectroscopy, a new method that is based on magnetic resonance imaging (MRI).

As predicted, their results found that there are indeed measurable differences in the skin of diabetes patients – and, in particular, diabetes patients with peripheral neuropathy – that can be detected before ulcerative foot disease develops.

"Our results indicated that the amount of oxygen that is available is reduced in the skin of patients with diabetes, and that this impairment is accentuated in the presence of neuropathy in the foot," write the authors. Furthermore, says Veves, their findings showed that energy reserves of the foot muscles are reduced in the presence of diabetes, suggesting that microcirculatory changes could [also] have a major role.

"Foot problems are the most common reason for hospitalization among patients with diabetes," notes Veves. "But they are also among the most preventable. If problems can be diagnosed early, then interventions can be made that will have important effects on clinical management of the diabetic foot."

Bonnie Prescott | EurekAlert!
Further information:
http://www.bidmc.harvard.edu

More articles from Health and Medicine:

nachricht Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University

nachricht Direct conversion of non-neuronal cells into nerve cells
03.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Subaru Telescope helps pinpoint origin of ultra-high energy neutrino

16.07.2018 | Physics and Astronomy

Barium ruthenate: A high-yield, easy-to-handle perovskite catalyst for the oxidation of sulfides

16.07.2018 | Life Sciences

New research calculates capacity of North American forests to sequester carbon

16.07.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>