Diabetic foot disease is a dreaded complication causing severe economic and social burden, mental and physical agony, and severe morbidity and mortality. This complication is largely preventable if the risk factors such as peripheral neuropathy and peripheral arterial disease are detected early and appropriate measures are taken to control glycemia, foot pressure, and chances of foot injury. In the case of ulceration, proper microbial control, pressure offloading by debridement, and use of appropriate footwear are mandatory to save the foot. This article focuses on the need for preventive care for diabetic complications demonstrating potentially helpful roles for industry in India.
Bakker K, Foster AVM, Van Hautum WH, Riley PC, eds. Diabetes and Foot Care: Time to Act. Brussels, Belgium: International Diabetes Federation; 2005.
5.
Most RS, Sinnock P.The epidemiology of lower limb extremity amputation in diabetic individuals . Diabetes Care. 1996; 19:1006-1009.
6.
Apelqvist J. , Larsson J., Agardh CDLong term prognosis for diabetic patients with foot ulcers. J Intern Med. 1993;235: 485-491.
7.
Apelqvist J. , Ragnarson, Tennvall G, Persson U., Larsson J.Diabetic foot ulcers in a multidisciplinary setting. An economic analysis of primary healing with amputation. J Intern Med. 1994;235;463-471.
8.
Sumpio BF, Lee T., Blume PAVascular evaluation and arterial reconstruction of the diabetic foot . Clin Podiatr Med Surg. 2003;20:689-708.
9.
Shobhana R., Rama Rao P., Lavanya A., Vijay V., Ramachandran A.Cost burden to diabetic patients with foot complications: a study from southern India. J Assoc Physicians India. 2000;48:1147-1150.
10.
Shobhana R. , Rama Rao P., Lavanya A., Williams R., Vijay V., Ramachandran A.Expenditure on health care incurred by diabetic subjects in a developing country: a study from southern India. Diabetes Res Clin Pract. 2000;48:37-42.
11.
Viswanathan V. , Sivagami M., Seena R., Snehalatha C., Ramachandran A.Amputation prevention initiative in south India: positive impact of foot care education . Diabetes Care . 2005;28:1019-1021.
12.
Prabhu KG, Patil KM, Srinivasan S.Diabetic feet at risk. A new method of analysis of walking foot pressure image at different levels of neuropathy for early detection of plantar ulcer . Med Biol Eng Comput.2001;39:288-293.
13.
American Diabetes Federation.Peripheral arterial disease in people with diabetes. Diabetes Care. 2003;26:333-341.
14.
Viswanathan V. , Sivagami M., Saraswathi G., et al. Effectiveness of different types of footwear insoles for the diabetic neuropathic foot. A follow up study. Diabetes Care. 2004;27: 474-477.
15.
Levin ME, O’Neal LW, Bowler JH , eds. The Diabetic Foot. 5th ed. St Louis, MO: C. V. Mosby ; 1993.
16.
Brem H., Tomic-Canic M.Cellular and molecular basis of wound healing in diabetes. J Clin Invest. 2007;117:1219-1222.
17.
Singer AJ, Clark RACutaneous wound healing. N Engl J Med. 1999 ;341:738-746.
18.
Anandi C., Alaguraja D., Natarajan V., et al. Bacteriology of diabetic foot lesions. Indian J Med Microbiol. 2004;22:175-178.
19.
Krishna Mohan V.Recombinant human epidermal growth factor (REGEN-D™ 150): Effect on healing of diabetic foot ulcers. Diabetes Res Clin Pract.2007;78:405-411.
20.
Broadley KN , Aquino AM, Hicks B., et al. Growth factors bFGF and TGF beta accelerate the rate of wound repair in normal and in diabetic rats. Int J Tissue React. 1988;10:345-353.
21.
Viswanathan V., Pendsey S., Sekar N., Murthy GSR.A phase III study to evaluate the safety and efficacy of rhEGF (REGEN-D150) in healing diabetic foot ulcers. Wounds. 2006;18: 186-196.
22.
Hoong JP, Jung HD, Kim YWRecombinant human epidermal growth factor (EGF) to enhance healing for diabetic foot ulcers. Ann Plast Surg. 2006;56:394-398.
23.
Ramsey SD, Newton K., Blough D., et al. Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care. 1999;22:382-387.
24.
Amputations linked to diabetes. http://www.hospitalmanagement.net/features/feature627/. Accessed on June 2, 2010.
25.
Vijay V., Sivagami M., Seena R., Snehalatha C., Ramachandran A.Urban-rural differences in the prevalence of foot complications in south Indian diabetic patients. Diabetes Care. 2006; 29:701-703.
