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.	中華醫學會糖尿病學分會, 中華醫學會感染病學分會, 中華醫學會組織修復與再生分會. 中國糖尿病足防治指南(2019 版)(Ⅰ). 中華糖尿病雜志, 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.	中華醫學會糖尿病學分會, 中華醫學會感染病學分會, 中華醫學會組織修復與再生分會. 中國糖尿病足防治指南(2019 版)(Ⅳ). 中華糖尿病雜志, 2019, 11(5): 316-327.
9.	石鴻雁, 許樟榮, 姜玉峰, 等. 血清白蛋白是良好的預測糖尿病足潰瘍截肢風險及醫療費用的臨床指標. 中華老年多器官疾病雜志, 2013(12): 919-923.
10.	池建昌, 陸祖謙, 張星哲. 糖尿病患者血糖波動幅度對糖尿病足的影響. 中華老年多器官疾病雜志, 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.	蔣竹奕, 謝穎, 楊川. 中國糖尿病足潰瘍患者預后危險因素研究進展. 中國糖尿病雜志, 2020, 28(7): 550-554.
13.	孟麗偉, 楊彩哲, 關小宏, 等. 糖尿病足患者并存無癥狀性心肌缺血危險因素分析. 中華老年醫學雜志, 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.	江雪蓮, 施建元, 張杉杉, 等. 糖尿病足潰瘍中左室射血分數正常心功能不全的患病情況與治療后改變. 中華內分泌代謝雜志, 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.	中國糖尿病足細胞與介入治療技術聯盟, 中國介入醫師分會介入醫學與生物工程技術委員會, 國家放射與治療臨床醫學研究中心. 糖尿病足介入綜合診治臨床指南(第六版). 介入放射學雜志, 2020, 29(9): 853-866.
24.	多學科合作下糖尿病足防治專家共識(2020 版)編寫組. 多學科合作下糖尿病足防治專家共識(2020 版)全版. 中華燒傷雜志, 2020, 36(8): E01-E52.
25.	胡慧萍, 陳明衛. 糖尿病足潰瘍愈合及截肢的相關因素分析. 安徽醫科大學學報, 2016, 51(11): 1634-1637.
26.	劉倩, 王鵬華, 張達, 等. 糖尿病足感染截肢(趾)相關危險因素分析. 天津醫藥, 2013, 41(2): 110-113.
27.	劉傳波, 黃瑤, 葉俊娜, 等. 糖尿病足潰瘍預后相關因素研究. 中華創傷雜志, 2014, 30(4): 291-297.
28.	楊文超, 趙珺, 梅家才, 等. 采用 WIFI 分級分析糖尿病足小截肢相關危險因素. 中國血管外科雜志(電子版), 2017, 9(1): 37-39.
29.	秦川, 蔣偉, 朱聚. 武漢市某醫院糖尿病足患者的焦慮、抑郁、自尊感及其相關性. 醫學與社會, 2018, 31(9): 72-74.
30.	陳利鴻, 冉興無. 糖尿病足的心理社會研究: 我們正在取得進步. 中華糖尿病雜志, 2020, 12(7): 451-455.

1. 中華醫學會糖尿病學分會, 中華醫學會感染病學分會, 中華醫學會組織修復與再生分會. 中國糖尿病足防治指南(2019 版)(Ⅰ). 中華糖尿病雜志, 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. 中華醫學會糖尿病學分會, 中華醫學會感染病學分會, 中華醫學會組織修復與再生分會. 中國糖尿病足防治指南(2019 版)(Ⅳ). 中華糖尿病雜志, 2019, 11(5): 316-327.
9. 石鴻雁, 許樟榮, 姜玉峰, 等. 血清白蛋白是良好的預測糖尿病足潰瘍截肢風險及醫療費用的臨床指標. 中華老年多器官疾病雜志, 2013(12): 919-923.
10. 池建昌, 陸祖謙, 張星哲. 糖尿病患者血糖波動幅度對糖尿病足的影響. 中華老年多器官疾病雜志, 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. 蔣竹奕, 謝穎, 楊川. 中國糖尿病足潰瘍患者預后危險因素研究進展. 中國糖尿病雜志, 2020, 28(7): 550-554.
13. 孟麗偉, 楊彩哲, 關小宏, 等. 糖尿病足患者并存無癥狀性心肌缺血危險因素分析. 中華老年醫學雜志, 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. 江雪蓮, 施建元, 張杉杉, 等. 糖尿病足潰瘍中左室射血分數正常心功能不全的患病情況與治療后改變. 中華內分泌代謝雜志, 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. 中國糖尿病足細胞與介入治療技術聯盟, 中國介入醫師分會介入醫學與生物工程技術委員會, 國家放射與治療臨床醫學研究中心. 糖尿病足介入綜合診治臨床指南(第六版). 介入放射學雜志, 2020, 29(9): 853-866.
24. 多學科合作下糖尿病足防治專家共識(2020 版)編寫組. 多學科合作下糖尿病足防治專家共識(2020 版)全版. 中華燒傷雜志, 2020, 36(8): E01-E52.
25. 胡慧萍, 陳明衛. 糖尿病足潰瘍愈合及截肢的相關因素分析. 安徽醫科大學學報, 2016, 51(11): 1634-1637.
26. 劉倩, 王鵬華, 張達, 等. 糖尿病足感染截肢(趾)相關危險因素分析. 天津醫藥, 2013, 41(2): 110-113.
27. 劉傳波, 黃瑤, 葉俊娜, 等. 糖尿病足潰瘍預后相關因素研究. 中華創傷雜志, 2014, 30(4): 291-297.
28. 楊文超, 趙珺, 梅家才, 等. 采用 WIFI 分級分析糖尿病足小截肢相關危險因素. 中國血管外科雜志(電子版), 2017, 9(1): 37-39.
29. 秦川, 蔣偉, 朱聚. 武漢市某醫院糖尿病足患者的焦慮、抑郁、自尊感及其相關性. 醫學與社會, 2018, 31(9): 72-74.
30. 陳利鴻, 冉興無. 糖尿病足的心理社會研究: 我們正在取得進步. 中華糖尿病雜志, 2020, 12(7): 451-455.

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Comprehensive and systematic evaluation: the basis of scientific and standardized diagnosis and treatment of diabetic foot ulcers

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