Literature Review: Role of Vitamin D in Diabetic Foot Ulcer Wound Healing

DFU is a common consequence of DM. Vitamin D has multiple positive effects on DFU. Search data from; Google Scholar, Science Direct, Elsevier, EBSCO, Medline and PubMed. Publication at least ten years (2013 until 2022). Inclusion criteria; full paper in English, Study about vitamin D and DFU in human, exclusion criteria; animal model and invitro study. Results; 27 journals; Seven Randomized Controlled Trial. Vitamin D phase on DFU which one substantially smaller. Severe vitamin D insufficiency known with significance linked for an elevated risk of DFU. Vitamin D supplementation can prevent or improve diabetic foot complication

The application of nanomedicine in clinical settings

As nanotechnology develops in the fields of mechanical engineering, electrical engineering, information and communication, and medical care, it has shown great promises. In recent years, medical nanorobots have made significant progress in terms of the selection of materials, fabrication methods, driving force sources, and clinical applications, such as nanomedicine. It involves bypassing biological tissues and delivering drugs directly to lesions and target cells using nanorobots, thus increasing concentration. It has also proved useful for monitoring disease progression, complementary diagnosis, and minimally invasive surgery. Also, we examine the development of nanomedicine and its applications in medicine, focusing on the use of nanomedicine in the treatment of various major diseases, including how they are generalized and how they are modified. The purpose of this review is to provide a summary and discussion of current research for the future development in nanomedicine

Prevención de la infección de la úlcera de pie diabético: una revisión integrativa

Antecedentes: La úlcera de pie diabético es uno de los problemas asociados a la diabetes mellitus de mayor relevancia por su gran impacto en la calidad de vida de los pacientes que la sufren y los riesgos o complicaciones que derivan de la misma. La infección es una de las complicaciones más comunes de dicha úlcera que resulta en amputaciones de las extremidades inferiores y mortalidad temprana en esta población. Objetivo principal: Analizar y sintetizar la información que existe, hasta el momento, sobre la prevención de la infección de la úlcera de pie diabético. Material y métodos: Se ha llevado a cabo una revisión integrativa de la literatura mediante una búsqueda exhaustiva en las siguientes bases de datos: Medline a través de Pubmed, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Web Of Science (WOS) y Cumulative Index to Nursing and Allied Health Literature (CINAHL). Se establecieron criterios de elegibilidad para la selección de los estudios apropiados para nuestro trabajo, de los que se evaluó la calidad a través de los checklist disponibles en Equator Network clasificándolos según su nivel de evidencia. Resultados: Se encontraron un total de 609 artículos de los cuales se realizó una lectura a texto completo de 57, excluyendo 39, quedando seleccionados, finalmente, 18 artículos. La mayoría de los estudios son observacionales y revisiones literarias. Conclusiones: La evidencia sobre la prevención de la infección en la úlcera de pie diabético es muy limitada a raíz de esta revisión. No obstante, la mayoría de los estudios encontrados coinciden en que la mejor manera de prevenir la infección de la úlcera de pie diabético es corregir y reducir al mínimo posible los factores de riesgo de infección y realizar una correcta educación al paciente

Utilizzo di fitopreparati come strategia per il trattamento di patologie causate da stress ossidativo.

Lo stress ossidativo è un processo che si sviluppa quando nell’organismo c’è uno squilibrio tra un’elevata produzione di specie reattive dell’ossigeno e un’inefficienza dei suoi sistemi antiossidanti. Inoltre, l’esposizione a sostanze esogene tossiche quali i metalli pesanti, il fumo e gli agenti inquinanti possono incrementarne la produzione. Nell’elaborato vengono descritti i principali sistemi antiossidanti endogeni-esogeni e i loro meccanismi di funzionamento al fine di poter prevenire, ridurre e inibire i processi ossidativi generati dalle specie radicaliche. Questi composti sono prodotti fisiologicamente dall’organismo umano, tuttavia, in grandi quantità, possono recare danno. Infatti, diversi studi affermano una correlazione diretta tra lo stress ossidativo e diverse patologie come il diabete, l’Alzheimer, l’ipertensione, l’artrite reumatoide, l’ictus e alcune neoplasie. Lo scopo principale del presente lavoro di tesi è stato quello di valutare, attraverso una attenta analisi della letteratura, i diversi aspetti dello stress ossidativo, le problematiche ad esso legate e le sostanze principalmente utilizzate come rimedio. L’analisi è stata focalizzata principalmente su due patologie: il Diabete e l’Alzheimer e su come queste ultime possano stimolare lo sviluppo di stress ossidativo. Nel caso del diabete, si è visto che l’iperglicemia, può essere controllata sia con la somministrazione di farmaci sintetici oppure attraverso l’utilizzo, sempre più diffuso, di fitopreparati. Infatti, è stato riportato come la berberina ottenuta da due piante officinali: Berberis vulgaris L. e Coptis chinensis L. e la galegina ottenuta da Galega officinalis L. abbia un effetto ipoglicemizzante e possa essere utilizzata per trattare il diabete mellito di tipo II. Nel caso invece dell’Alzheimer si è visto come lo stress ossidativo partecipi alla patogenesi, promuovendo la deposizione di placca β-amiloide e la formazione di grovigli neurofibrillari di tau iperfosforilata. Il principale rimedio farmacologico nel trattamento dell’Alzheimer consiste nell’utilizzare inibitori dell’acetilcolinasterasi, ad esempio il Donepezil. Diversi studi pero’ affermano come la curcumina ottenuta dalla pianta Curcuma Longa L. e i ginsenosidi ottenuti dalla pianta Panax ginseng L. contribuiscano a prevenire le cause di patogenesi dell’Alzheimer e a migliorare le funzioni cognitive di persone affette da questa patologia. E’ noto inoltre che l’utilizzo di fitopreparati possa aiutare a contrastare i sintomi e lo sviluppo di diverse patologie. Per questi motivi, sono state anche riportate le caratteristiche generali di due piante ad alto contenuto antiossidante: Ginko biloba L. e Vaccinium myrtillus L. Dagli studi riportati e discussi in questo lavoro si evince come i flavonoidi e i ginkgolidi presenti nel ginko conferiscano al fitopreparato un’azione antiossidante, vasoprotettiva e antidolorifica, la quale potrebbe contribuire a contrastare l’Alzheimer, la sindrome di Raynaud e problemi associati al diabete. Ugualmente i flavonoidi, tannini, antociani presenti nella pianta di mirtillo attribuiscono al fitopreparato proprietà antiossidanti, ipoglicemizzanti e antidiarroica utili per trattare Alzheimer, diabete e stress ossidativo

Diabetes mellitus and diabetic foot ulcer: Etiology, biochemical and molecular based treatment strategies via gene and nanotherapy

Diabetes mellitus (DM) is a collection of metabolic and pathophysiological disorders manifested with high glucose levels in the blood due to the inability of β-pancreatic cells to secrete an adequate amount of insulin or insensitivity of insulin towards receptor to oxidize blood glucose. Nevertheless, the preceding definition is only applicable to people who do not have inherited or metabolic disorders. Suppose a person who has been diagnosed with Type 1 or Type 2DM sustains an injury and the treatment of the damage is complicated and prolonged. In that case, the injury is referred to as a diabetic foot ulcer (DFU). In the presence of many proliferating macrophages in the injury site for an extended period causes the damage to worsen and become a diabetic wound. In this review, the scientific information and therapeutic management of DM/DFU with nanomedicine, and other related data were collected (Web of Science and PubMed) from January 2000 to January 2022. Most of the articles revealed that standard drugs are usually prescribed along with hypoglycaemic medications. Conversely, such drugs stabilize the glucose transporters and homeostasis for a limited period, resulting in side effects such as kidney damage/failure, absorption/gastrointestinal problems, and hypoglycemic issues. In this paper, we review the current basic and clinical evidence about the potential of medicinal plants, gene therapy, chemical/green synthesized nanoparticles to improving the metabolic profile, and facilitating the DM and DFU associated complications. Preclinical studies also reported lower plasma glucose with molecular targets in DM and DFU. Research is underway to explore chemical/green synthesized nanoparticle-based medications to avoid such side effects. Hence, the present review is intended to address the current challenges, recently recognized factors responsible for DM and DFU, their pathophysiology, insulin receptors associated with DM, medications in trend, and related complications. © 2022TRU

Fragile Feet and Trivial Trauma: Communicating the Etiology of Diabetic Foot Ulcers to Patients

People at risk for diabetic foot ulcer (DFU) often misunderstand why foot ulcers develop and what self-care strategies may help prevent them. The etiology of DFU is complex and difficult to communicate to patients, which may hinder effective self-care. Thus, we propose a simplified model of DFU etiology and prevention to aid communication with patients. The Fragile Feet & Trivial Trauma model focuses on two broad sets of risk factors: predisposing and precipitating. Predisposing risk factors (eg, neuropathy, angiopathy, and foot deformity) are usually lifelong and result in "fragile feet." Precipitating risk factors are usually different forms of everyday trauma (eg, mechanical, thermal, and chemical) and can be summarized as "trivial trauma." We suggest that the clinician consider discussing this model with their patient in three steps: 1) explain how a patient's specific predisposing risk factors result in fragile feet for the rest of life, 2) explain how specific risk factors in a patient's environment can be the trivial trauma that triggers development of a DFU, and 3) discuss and agree on with the patient measures to reduce the fragility of the feet (eg, vascular surgery) and prevent trivial trauma (eg, wear therapeutic footwear). By this, the model supports the communication of two essential messages: that patients may have a lifelong risk of ulceration but that there are health-care interventions and self-care practices that can reduce these risks. The Fragile Feet & Trivial Trauma model is a promising tool for aiding communication of foot ulcer etiology to patients. Future studies should investigate whether using the model results in improved patient understanding and self-care and, in turn, contributes to lower ulceration rates