Comprehensive and systematic evaluation: the basis of scientific and standardized diagnosis and treatment of diabetic foot ulcers_West China Medical Journal

Authors：

WANG Aihong ,  XU Zhangrong

Department of Endocrinology, Strategic Support Force Medical Center, Beijing 100101, P. R. China;

Corresponding author：

XU Zhangrong, Email: xzr1021@vip.sina.com

Keywords：

Diabetic foot ulcers; Comprehensive and systematic evaluation; Scientific and standard; Diagnosis and treatment

DOI：

10.7507/1002-0179.202103068

Video：

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Diabetic foot ulcer (DFU) is one of the most serious complications of diabetes mellitus. Considering complicated conditions, poor general condition, severe infection and poor outcomes as the feature characteristics of Chinese DFU patients, comprehensive and systematic evaluation, including general condition, region of the foot, and psychological status, is essential and fundamental for successful treatment. This commentary summarizes the evaluation contents in scientific and standardized diagnosis and treatment of diabetic foot ulcer, and looking forward to reducing morbidity, recurrence rate and mortality, and increasing limb salvage rate.

Citation： WANG Aihong, XU Zhangrong. Comprehensive and systematic evaluation: the basis of scientific and standardized diagnosis and treatment of diabetic foot ulcers. West China Medical Journal, 2021, 36(4): 432-435. doi: 10.7507/1002-0179.202103068 Copy

1.	中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019 版)(Ⅰ). 中华糖尿病杂志, 2019, 11(2): 92-108.
2.	International Diabetes Federation (IDF) and the International Working Group on the Diabetic Foot (IWGDF). Diabetes and foot care: time to act. (2005-11-14)[2021-03-29]. https://www.worlddiabetesfoundation.org/files/diabetes-and-foot-care-time-act.
3.	Lazzarini PA, Pacella RE, Armstrong DG, et al. Diabetes-related lower-extremity complications are a leading cause of the global burden of disability. Diabet Med, 2018, 35(9): 1297-1299.
4.	Jiang Y, Wang X, Xia L, et al. A cohort study of diabetic patients and diabetic foot ulceration patients in China. Wound Repair Regen, 2015, 23(2): 222-230.
5.	Xu Z, Ran X. Diabetic foot care in China: challenges and strategy. Lancet Diabetes Endocrinol, 2016, 4(4): 297-298.
6.	Gurney JK, Stanley J, York S, et al. Risk of lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetologia, 2018, 61(3): 626-635.
7.	Zhang SS, Tang ZY, Fang P, et al. Nutritional status deteriorates as the severity of diabetic foot ulcers increases and independently associates with prognosis. Exp Ther Med, 2013, 5(1): 215-222.
8.	中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019 版)(Ⅳ). 中华糖尿病杂志, 2019, 11(5): 316-327.
9.	石鸿雁, 许樟荣, 姜玉峰, 等. 血清白蛋白是良好的预测糖尿病足溃疡截肢风险及医疗费用的临床指标. 中华老年多器官疾病杂志, 2013(12): 919-923.
10.	池建昌, 陆祖谦, 张星哲. 糖尿病患者血糖波动幅度对糖尿病足的影响. 中华老年多器官疾病杂志, 2012, 11(7): 498-501.
11.	Peled S, Pollack R, Elishoov O, et al. Association of inpatient glucose measurements with amputations in patients hospitalized with acute diabetic foot. J Clin Endocrinol Metab, 2019, 104(11): 5445-5452.
12.	蒋竹奕, 谢颖, 杨川. 中国糖尿病足溃疡患者预后危险因素研究进展. 中国糖尿病杂志, 2020, 28(7): 550-554.
13.	孟丽伟, 杨彩哲, 关小宏, 等. 糖尿病足患者并存无症状性心肌缺血危险因素分析. 中华老年医学杂志, 2015, 34(1): 55-58.
14.	Tang ZH, Zeng F, Li Z, et al. Association and predictive value analysis for resting heart rate and diabetes mellitus on cardiovascular autonomic neuropathy in general population. J Diabetes Res, 2014, 2014: 215473.
15.	Xu L, Qian H, Gu J, et al. Heart failure in hospitalized patients with diabetic foot ulcers: clinical characteristics and their relationship with prognosis. J Diabetes, 2013, 5(4): 429-438.
16.	江雪莲, 施建元, 张杉杉, 等. 糖尿病足溃疡中左室射血分数正常心功能不全的患病情况与治疗后改变. 中华内分泌代谢杂志, 2011, 27(7): 580-583.
17.	Maltese G, Fountoulakis N, Drakatos P, et al. Elevated obstructive sleep apnoea risk score is associated with poor healing of diabetic foot ulcers: a prospective cohort study. Diabet Med, 2018, 35: 1494-1498.
18.	Chen L, Ma W, Tang W, et al. Prevalence of obstructive sleep apnea in patients with diabetic foot ulcers. Front Endocrinol (Lausanne), 2020, 11: 416.
19.	He Y, Qian H, Xu L, et al. Association between estimated glomerular filtration rate and outcomes in patients with diabetic foot ulcers: a 3-year follow-up study. Eur J Endocrinol, 2017, 177(1): 41-50.
20.	Serban D, Papanas N, Dascalu AM, et al. Diabetic retinopathy in patients with diabetic foot ulcer: a systematic review. Int J Low Extrem Wounds, 2020, 22: 1534734620982237.
21.	Sellman A, Katzman P, Andreasson S, et al. Presence of chronic diabetic foot ulcers is associated with more frequent and more advanced retinopathy. Diabet Med, 2018, 35(10): 1364-1370.
22.	Schaper NC, van Netten JJ, Apelqvist J, et al. Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update). Diabetes Metab Res Rev, 2020, 36(Suppl 1): e3266.
23.	中国糖尿病足细胞与介入治疗技术联盟, 中国介入医师分会介入医学与生物工程技术委员会, 国家放射与治疗临床医学研究中心. 糖尿病足介入综合诊治临床指南(第六版). 介入放射学杂志, 2020, 29(9): 853-866.
24.	多学科合作下糖尿病足防治专家共识(2020 版)编写组. 多学科合作下糖尿病足防治专家共识(2020 版)全版. 中华烧伤杂志, 2020, 36(8): E01-E52.
25.	胡慧萍, 陈明卫. 糖尿病足溃疡愈合及截肢的相关因素分析. 安徽医科大学学报, 2016, 51(11): 1634-1637.
26.	刘倩, 王鹏华, 张达, 等. 糖尿病足感染截肢(趾)相关危险因素分析. 天津医药, 2013, 41(2): 110-113.
27.	刘传波, 黄瑶, 叶俊娜, 等. 糖尿病足溃疡预后相关因素研究. 中华创伤杂志, 2014, 30(4): 291-297.
28.	杨文超, 赵珺, 梅家才, 等. 采用 WIFI 分级分析糖尿病足小截肢相关危险因素. 中国血管外科杂志(电子版), 2017, 9(1): 37-39.
29.	秦川, 蒋伟, 朱聚. 武汉市某医院糖尿病足患者的焦虑、抑郁、自尊感及其相关性. 医学与社会, 2018, 31(9): 72-74.
30.	陈利鸿, 冉兴无. 糖尿病足的心理社会研究: 我们正在取得进步. 中华糖尿病杂志, 2020, 12(7): 451-455.

1. 中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019 版)(Ⅰ). 中华糖尿病杂志, 2019, 11(2): 92-108.
2. International Diabetes Federation (IDF) and the International Working Group on the Diabetic Foot (IWGDF). Diabetes and foot care: time to act. (2005-11-14)[2021-03-29]. https://www.worlddiabetesfoundation.org/files/diabetes-and-foot-care-time-act.
3. Lazzarini PA, Pacella RE, Armstrong DG, et al. Diabetes-related lower-extremity complications are a leading cause of the global burden of disability. Diabet Med, 2018, 35(9): 1297-1299.
4. Jiang Y, Wang X, Xia L, et al. A cohort study of diabetic patients and diabetic foot ulceration patients in China. Wound Repair Regen, 2015, 23(2): 222-230.
5. Xu Z, Ran X. Diabetic foot care in China: challenges and strategy. Lancet Diabetes Endocrinol, 2016, 4(4): 297-298.
6. Gurney JK, Stanley J, York S, et al. Risk of lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetologia, 2018, 61(3): 626-635.
7. Zhang SS, Tang ZY, Fang P, et al. Nutritional status deteriorates as the severity of diabetic foot ulcers increases and independently associates with prognosis. Exp Ther Med, 2013, 5(1): 215-222.
8. 中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019 版)(Ⅳ). 中华糖尿病杂志, 2019, 11(5): 316-327.
9. 石鸿雁, 许樟荣, 姜玉峰, 等. 血清白蛋白是良好的预测糖尿病足溃疡截肢风险及医疗费用的临床指标. 中华老年多器官疾病杂志, 2013(12): 919-923.
10. 池建昌, 陆祖谦, 张星哲. 糖尿病患者血糖波动幅度对糖尿病足的影响. 中华老年多器官疾病杂志, 2012, 11(7): 498-501.
11. Peled S, Pollack R, Elishoov O, et al. Association of inpatient glucose measurements with amputations in patients hospitalized with acute diabetic foot. J Clin Endocrinol Metab, 2019, 104(11): 5445-5452.
12. 蒋竹奕, 谢颖, 杨川. 中国糖尿病足溃疡患者预后危险因素研究进展. 中国糖尿病杂志, 2020, 28(7): 550-554.
13. 孟丽伟, 杨彩哲, 关小宏, 等. 糖尿病足患者并存无症状性心肌缺血危险因素分析. 中华老年医学杂志, 2015, 34(1): 55-58.
14. Tang ZH, Zeng F, Li Z, et al. Association and predictive value analysis for resting heart rate and diabetes mellitus on cardiovascular autonomic neuropathy in general population. J Diabetes Res, 2014, 2014: 215473.
15. Xu L, Qian H, Gu J, et al. Heart failure in hospitalized patients with diabetic foot ulcers: clinical characteristics and their relationship with prognosis. J Diabetes, 2013, 5(4): 429-438.
16. 江雪莲, 施建元, 张杉杉, 等. 糖尿病足溃疡中左室射血分数正常心功能不全的患病情况与治疗后改变. 中华内分泌代谢杂志, 2011, 27(7): 580-583.
17. Maltese G, Fountoulakis N, Drakatos P, et al. Elevated obstructive sleep apnoea risk score is associated with poor healing of diabetic foot ulcers: a prospective cohort study. Diabet Med, 2018, 35: 1494-1498.
18. Chen L, Ma W, Tang W, et al. Prevalence of obstructive sleep apnea in patients with diabetic foot ulcers. Front Endocrinol (Lausanne), 2020, 11: 416.
19. He Y, Qian H, Xu L, et al. Association between estimated glomerular filtration rate and outcomes in patients with diabetic foot ulcers: a 3-year follow-up study. Eur J Endocrinol, 2017, 177(1): 41-50.
20. Serban D, Papanas N, Dascalu AM, et al. Diabetic retinopathy in patients with diabetic foot ulcer: a systematic review. Int J Low Extrem Wounds, 2020, 22: 1534734620982237.
21. Sellman A, Katzman P, Andreasson S, et al. Presence of chronic diabetic foot ulcers is associated with more frequent and more advanced retinopathy. Diabet Med, 2018, 35(10): 1364-1370.
22. Schaper NC, van Netten JJ, Apelqvist J, et al. Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update). Diabetes Metab Res Rev, 2020, 36(Suppl 1): e3266.
23. 中国糖尿病足细胞与介入治疗技术联盟, 中国介入医师分会介入医学与生物工程技术委员会, 国家放射与治疗临床医学研究中心. 糖尿病足介入综合诊治临床指南(第六版). 介入放射学杂志, 2020, 29(9): 853-866.
24. 多学科合作下糖尿病足防治专家共识(2020 版)编写组. 多学科合作下糖尿病足防治专家共识(2020 版)全版. 中华烧伤杂志, 2020, 36(8): E01-E52.
25. 胡慧萍, 陈明卫. 糖尿病足溃疡愈合及截肢的相关因素分析. 安徽医科大学学报, 2016, 51(11): 1634-1637.
26. 刘倩, 王鹏华, 张达, 等. 糖尿病足感染截肢(趾)相关危险因素分析. 天津医药, 2013, 41(2): 110-113.
27. 刘传波, 黄瑶, 叶俊娜, 等. 糖尿病足溃疡预后相关因素研究. 中华创伤杂志, 2014, 30(4): 291-297.
28. 杨文超, 赵珺, 梅家才, 等. 采用 WIFI 分级分析糖尿病足小截肢相关危险因素. 中国血管外科杂志(电子版), 2017, 9(1): 37-39.
29. 秦川, 蒋伟, 朱聚. 武汉市某医院糖尿病足患者的焦虑、抑郁、自尊感及其相关性. 医学与社会, 2018, 31(9): 72-74.
30. 陈利鸿, 冉兴无. 糖尿病足的心理社会研究: 我们正在取得进步. 中华糖尿病杂志, 2020, 12(7): 451-455.

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