Tuesday, May 20, 2025

आशियातील पोषण आणि निरोगी वृद्धत्व: एक पद्धतशीर पोषक घटक.

 सारांश


पार्श्वभूमी: निरोगी वृद्धत्वाची शक्यता नियंत्रित करण्यात पोषण महत्त्वाची भूमिका बजावते. सध्याच्या अभ्यासात, आशियातील निरोगी वृद्धत्वावर पोषणाचा 

प्रभाव मूल्यांकन करण्यासाठी आम्ही एक पद्धतशीर पुनरावलोकन करण्याचे उद्दिष्ट ठेवले आहे.


पद्धती: पद्धतशीर पुनरावलोकन इंटरनॅशनल प्रॉस्पेक्टिव्ह रजिस्टर ऑफ सिस्टिमॅटिक रिव्ह्यूज डेटाबेस (CRD42023408936) मध्ये नोंदणीकृत केले गेले होते आणि 

सिस्टिमॅटिक रिव्ह्यूज आणि मेटा-अ‍ॅनालिसिस मार्गदर्शक तत्त्वांसाठी पसंतीचे

 रिपोर्टिंग आयटम्सच्या आधारे केले गेले होते. फेब्रुवारी २०२३ 

पर्यंत पबमेड, वेब ऑफ सायन्स आणि एम्बेस डेटाबेस भाषेच्या 

निर्बंधांशिवाय शोधले गेले. आम्ही संभाव्य गट अभ्यासांचा समावेश केला 

ज्यामध्ये मध्यमवयीन वयात एकाच अन्नाचे सेवन किंवा 

एकाच पोषक तत्वाचे सेवन यांच्यातील संबंधांचे मूल्यांकन केले गेले; 

मध्यमवयीन वयात विविध आहार पद्धतींचे पालन; आणि मध्यमवयीन वयापासून उशिरापर्यंत आहार पद्धतींचे पालन निरोगी वृद्धत्व आणि त्याच्या घटकांच्या शक्यतेसह सुधारले गेले.


निकाल: १६,३७३ नोंदींपैकी, आम्ही सिंगापूर, चीन, जपान आणि थायलंडमधील २४ गटांचा समावेश असलेले ७१ पेपर समाविष्ट केले. निरोगी वृद्धत्व घटकांमध्ये संज्ञानात्मक कार्य, 

शारीरिक कार्य आणि नैराश्य यांचा समावेश होता. 

बहुतेक अभ्यासांनी या निरीक्षणाचे समर्थन केले की 

मध्यमवयीन वयात भाज्या, फळे, मासे, काजू, शेंगा, चहा, दूध आणि दुग्धजन्य

 पदार्थ यासारख्या निरोगी पदार्थांच्या जास्त सेवनाने

 आणि उच्च विविधता स्कोअर किंवा उच्च एकूण अँटिऑक्सिडंट

 क्षमता असलेल्या आहार पद्धतींचे जास्त पालन केल्याने उशिरापर्यंत निरोगी वृद्धत्व 

आणि त्याच्या घटकांची शक्यता सकारात्मकरित्या वाढली. 

शिवाय, मध्यमवयीन वयापासून उशिरापर्यंत निरोगी 

आहार पद्धतींचे सुधारित पालन केल्याने उशिरापर्यंत निरोगी वृद्धत्वाची शक्यता देखील वाढली.


 निष्कर्ष: मध्यम वयात निरोगी अन्न खाणे आणि निरोगी आहार 

पद्धतींचे पालन केल्याने निरोगी वृद्धत्वाची शक्यता वाढते. 

शिवाय, मध्यम वयापासून ते उशिरापर्यंत 

आहाराची गुणवत्ता सुधारणे अजूनही फायदेशीर ठरू शकते.

Ref

Nutrients. 2023 Jul 14;15(14):3153. doi: 10.3390/nu15143153

Nutrition and Healthy Ageing in Asia: A Systematic Nutrients. 2023 Jul 14;15(14):3153. doi: 10.3390/nu1514315: A Systematic ReviewYan-Feng Zhou 1,*,†, Xing-Yue Song 2,†, An Pan 3, Woon-Puay Koh 4,5

Editors: Maria Luz Fernandez, Joanne Brooke

Nutrtion and Healthy Aging in Asia

 Nutrients. 2023 Jul 14;15(14):3153. doi: 10.3390/nu15143153

Nutrition and Healthy Ageing in Asia: A Systematic Review

Yan-Feng Zhou 1,*,†, Xing-Yue Song 2,†, An Pan 3, Woon-Puay Koh 4,5

Editors: Maria Luz Fernandez, Joanne Brooke



Abstract

Background: Nutrition plays a key role in modulating the likelihood of healthy ageing. In the present study, we aimed to conduct a systematic review to assess the impact of nutrition on healthy ageing in Asia.


Methods: The systematic review was registered in the International Prospective Register of Systematic Reviews database (CRD42023408936) and conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Web of Science, and Embase databases were searched up to February 2023 without language restrictions. We included prospective cohort studies that evaluated the associations of intake of a single food or consumption of a single nutrient at midlife; adherence to various dietary patterns at midlife; and improved adherence to dietary patterns from mid- to late life with the likelihood of healthy ageing and its components.


Results: Out of 16,373 records, we included 71 papers comprising 24 cohorts from Singapore, China, Japan, and Thailand. The healthy ageing components included cognitive function, physical function, and depression. The majority of studies supported the observation that the likelihood of healthy ageing and its components in late life was positively increased by a higher consumption of healthy foods, such as vegetables, fruits, fish, nuts, legumes, tea, milk, and dairy, at midlife, and also by greater adherence to dietary patterns with high diversity scores or high total antioxidant capacities. Furthermore, improved adherence to healthy dietary patterns from mid- to late life also increased the likelihood of healthy ageing in late life.


Conclusion: Consuming healthy foods and adhering to healthy dietary patterns at midlife can promote the likelihood of healthy ageing. Moreover, improving diet quality from mid- to late life can still be beneficial.



Modulation of aging

 Nonetheless, and despite many studies on aging, this subject remains poorly understood [, ]. 

Over the last 7 decades, human lifespan

 has steeply increased, which was reflected in the global population – as a result,

 the population of individuals over age 60 has increased dramatically from 205 million in 1950 to 1 billion in 2019.

 According to a World Health Organization (WHO) prediction, by 2030, individuals over 60 years old will outnumber children younger than 10 years old, and by 2050 the over-60 population will number 2.1 billion []. 


On the one hand, this extended lifespan is a tribute to the technological advances achieved in

 the last century, in terms 

of health, medicine, sanitation, and education.

 On the other hand, such increase of aged populations sets pressure on societies to develop specialized policies and services for the elderly, to reduce the impact of this trend on our communities [].

The decade of 2020–2030 was termed by the WHO as the “Decade of Healthy Aging”, 

with the target of sustainably extending healthspan []

. WHO has defined “Healthy Aging” as the possibility 

for everyone to be and do what they 

value throughout their life. For older adults, this means remaining independent and capable of participating in their daily activities, even if affected by illness [].


Ref Aging (Albany NY). 2023 Apr 20;15(8):3191–3217. doi: 10.18632/aging.204668

How can we modulate aging through nutrition and physical exercise? An epigenetic approach
Ana Teresa Rajado 1,2, Nádia Silva 1,2, Filipa Esteves 1,2, David Brito 1,2, Alexandra Binnie 1,2,3,4, Inês M Araújo 1,2,3,5, Clévio Nóbrega 1,2,3,5, José Bragança 1,2,3,5, Pedro Castelo-Branco 1,2,3,5,✉; ALFA Score Consortium

How can we modulate aging?

 Aging is a complex time-dependent multifactorial biological process, involving a gradual decline in cognitive and physiological functions over time. 

This results in a reduced capacity to respond to stressors, which in turn increases morbidity and mortality [1–3]. 

Pathological phenotypes associated with aging 

include frailty (a condition associated with progressive physical and mental decline [4], 

chronic medical conditions, such as diabetes and cardiovascular disease [5, 

6], visual impairment, for example age-related macular disease [7, 8], cancer [9], 

and neurodegenerative disorders, such as Alzheimer’s, Parkinson’s and Huntington’s diseases [10, 11]

, to name some of the most prevalent.

Ref
Aging (Albany NY). 2023 Apr 20;15(8):3191–3217. doi: 10.18632/aging.204668
How can we modulate aging through nutrition and physical exercise? An epigenetic approach
Ana Teresa Rajado 1,2, Nádia Silva 1,2, Filipa Esteves 1,2, David Brito 1,2, Alexandra Binnie 1,2,3,4, Inês M Araújo 1,2,3,5, Clévio Nóbrega 1,2,3,5, José Bragança 1,2,3,5, Pedro Castelo-Branco 1,2,3,5,✉; ALFA Score Consortium*

Monday, May 19, 2025

आरोग्य कालावधी वाढवणे आणि सार्वजनिक आरोग्य

 

 आरोग्य कालावधी वाढवणे हे सार्वजनिक 

आरोग्यासाठी एक मोठे आव्हान आहे.

आहार हा


वयाशी संबंधित आजार रोखण्यासाठी आणि

वृद्धत्वादरम्यान एकूणच चांगली आरोग्य स्थिती टिकवून ठेवण्यासाठी सुधारित घटकांपैकी एक आहे.

व्यक्तींच्या अंतर्गत क्षमतेचे ऑप्टिमायझेशन,

ज्ञान क्षेत्रातील क्षेत्रांसह,

मानसिक, संवेदी कार्य, चैतन्य आणि हालचाल, हे

 जागतिक आरोग्य संघटनेने निरोगी वृद्धत्वाचे एक मॉडेल म्हणून प्रस्तावित केले आहे.

निरोगी आहार आणि निरोगी वृद्धत्व यांच्यातील संबंध अधिक चांगल्या प्रकारे समजून घेण्यासाठी, हे पुनरावलोकन निरोगी वृद्धत्वाच्या (डोमेन) मध्ये भूमिका बजावणारे दर्शविलेल्या आहाराच्या नमुन्यांसाठी अलिकडच्या महामारीविज्ञान आणि क्लिनिकल डेटाचा सारांश देते. प्रायोरी किंवा पोस्टेरोरी

आहारविषयक नमुने, असे दिसून येते की वनस्पती-आधारित अन्नांवर केंद्रित

 आहाराच्या नमुन्यांचा निरोगी वृद्धत्वाच्या (डोमेन) मध्ये फायदेशीर भूमिका आहे.

आमच्या पुनरावलोकनात आहाराच्या नमुन्यांमध्ये आणि निरोगी वृद्धत्वाच्या बहुआयामी संकल्पनांमध्ये ज्ञानातील तफावत आढळली.  निरोगी आहार आणि निरोगी वृद्धत्वाच्या बहुआयामी संकल्पनांबद्दलची आपली समज वाढवण्यासाठी अधिक महामारीविज्ञान अभ्यासांनी आंतरिक क्षमतेचा परिणाम उपाय म्हणून विचार केला पाहिजे.

जेव्हा पुरेशा प्रमाणात महामारीविज्ञान अभ्यास उपलब्ध असतात,

 तेव्हा पुरावे संश्लेषित केले जाऊ शकतात आणि निरोगी वृद्धत्वासाठी एक धोरण म्हणून निरोगी आहाराचे मूल्यांकन करण्यासाठी क्लिनिकल चाचण्या तयार केल्या जाऊ शकतात जेणेकरून पुरावे सराव करण्यासाठी आणि निरोगी वृद्धत्वाला प्रोत्साहन देण्यासाठी आपली प्रगती पुढे नेली जाऊ शकेल.


Ref

 Nutrients

. 2021 Nov 29;13(12):4310. doi: 10.3390/nu13124310


Healthy Diet for Healthy Aging

Suey S Y Yeung 1, Michelle Kwan 2, Jean Woo 1,3,*

Editors: Martina Barchitta, Arrigo Cicero, Federica Fogacci, Claudio Borghi

Healthy diet for healthy ageing

 Extending healthspan is a major public health challenge.

 Diet is one of the modifiable factors for 

preventing age-related diseases and preserving 

overall good health status during aging. 

Optimizing individuals’ intrinsic capacity,

 including domains in cognition,

 psychological, sensory function, vitality, and locomotion, has been proposed as a model of healthy aging by the World Health Organization. 

To better understand the relationships between a healthy diet and healthy aging, this review summarizes the recent epidemiologic and clinical data for dietary patterns that have been shown to play a role in (domains of) healthy aging. Regardless of priori or posteriori 

dietary patterns, it appears that dietary patterns centered on plant-based foods have a beneficial role in (domains of) healthy aging. 

Our review identified a knowledge gap in dietary patterns and multidimensional concepts of healthy aging. More epidemiological studies should consider intrinsic capacity as an outcome measure to further our understanding of a healthy diet and multidimensional concepts of healthy aging.

 When a sufficient number of epidemiological studies is available, evidence can be synthesized and clinical trials can be designed to evaluate a healthy diet as a strategy for healthy aging to further our progress in translating evidence to practice and promoting healthy ageing 

Ref

. 2021 Nov 29;13(12):4310. doi: 10.3390/nu13124310

Healthy Diet for Healthy Aging

Editors: Martina BarchittaArrigo CiceroFederica FogacciClaudio Borghi

Nutrtion Food and Diet in Health and Longivity



Abstract
Nutrition generally refers to the macro- and micro-nutrients essential for survival, but we do not simply eat nutrition. Instead, we eat animal- and plant-based foods without always being conscious of its nutritional value. Furthermore, various cultural factors influence and shape our taste, preferences, taboos and practices towards preparing and consuming food as a meal and diet. Biogerontological understanding of ageing has identified food as one of the three foundational pillars of health and survival. Here we address the issues of nutrition, food and diet by analyzing the biological importance of macro- and micro-nutrients including hormetins, discussing the health claims for various types of food, and by reviewing the general principles of healthy dietary patterns, including meal timing, caloric restriction, and intermittent fasting. We also present our views about the need for refining our approaches and strategies for future research on nutrition, food and diet by incorporating the molecular, physiological, cultural and personal aspects of this crucial pillar of health, healthy ageing and longevity.


Ref Nutrients

. 2022 Dec 18;14(24):5376. doi: 10.3390/nu14245376

Nutrition, Food and Diet in Health and Longevity: We Eat What We Are

Editors: M Cristina PolidoriCornel SieberAnna Maria Meyer

Nutrtion Diet and Healthy Ageing

  Ref Nutrients. 2021 Dec 31;14(1):190. doi: 10.3390/nu14010190

Nutrition, Diet and Healthy Aging

Emiliana Giacomello 1,*, Luana Toniolo 2,*




The current increase in life expectancy is confirmed by data from different sources (i.e., The World Population Prospects 2019 issued by the United Nations; https://population.un.org/wpp/ (accessed on 20 December 2021)), 

which predict that, in the near future, individuals who are over 65 and over 80 will be the fastest-growing portion of the population.


Although the increase in lifespan is a positive effect of the world’s improved sanitary, nutritional, and socioeconomic conditions, it is not free of complications. 

Actually, this improved lifespan is associated with an

 intensification of chronic diseases, such as cardiovascular disease, diabetes, cancer, sarcopenia, and degenerative disorders, which are grouped into what are called non-communicable diseases.


Aging is determined by the functional alteration

 of cell- and organ-related mechanisms that contribute to the functional decline of the individual. These alterations converge to a complex condition called frailty,

 where the individual experiences a loss of physical and psychological abilities,

 leading to a state of increased risk for adverse health outcomes in several pathologies.


At present, the frailty index is a clinically evaluated

 method that can be used to assess the quality of aging, 

which depends on the individual’s exposition to 

different physical activities, nutritional regimens,

 and other socioeconomic characteristics.

 Therefore, frailty results in a modifiable condition that can be improved with affordable adjustments in lifestyle, such as following a nutritional regimen that meets the needs of aged people.


The aim of this Special Issue titled

 “Nutrition and Healthy Ageing” is to provide an overview on the connection between 

nutrition and aging, update knowledge on the mechanisms that are responsible for aging, and report on nutritional strategies that can be implemented to overcome age-related diseases.


This Special Issue collects 14

 research articles and 4 reviews that span from

 studies in the population to basic research on

 experimental models. Overall, the collection touches

 themes

 such as dietary diversity, calorie restriction regimens, 

physical exercise, antiaging agents, social issues,

 and strategies to promote healthy aging. Attesting to the widespread interest in the correlation between nutrition and healthy aging, the current issue reports data on the correlation between diet 

and healthy aging from China, Italy, Korea, Malaysia, 

Mexico, Saudi Arabia, Spain, and the United States of America.


The most marked message that emerges from this collection is the correlation between the frailty index and dietary diversity. 

Studies from different countries with very

 diverse nutritional habits show that aged individuals with a good diet variety score present a better frailty index [1,2,3,4,5,6,7,8,9,10]. 

Evidently, due to the diverse geographical origin of the

 data, it is difficult to infer

 what the best diet to avoid or to postpone the occurrence of frailty is. Moreover, as determined by the study of 

Avila and collaborators [11], other

 socioeconomic factors can increase the risk of malnutrition and can negatively influence the health status of aging people.


The maintenance of mental capacities is one important factor that characterizes healthy aging. 

As raised by work from Liu and collaborators [7]

 from and Zhang [2] and collaborators, 

the psychological conditions of aged people could also be correlated with dietary variety, and a 

high intake of carbohydrates and 

fat could be associated with memory impairment.


Although we are far from identifying an ideal diet for a healthy aging,

 it can be summarized that adherence to Mediterranean diet

 for Europeans [5], the use of a balanced diet rich in vegetables 

in U.S. [3], and the 

general balanced equilibrium of 

vegetables, oil, fish, and meat in the diet seems to have a major role in maintaining a lower frailty index and in the prevention of the non-communicable diseases.


The fact that aging is a multifaceted phenomenon that 

results from one or more failures at the molecular, 

cellular, physiologic, and functional levels,

 makes age-related diseases challenging therapeutic targets. Moreover, studies on aging and antiaging agents in humans can be difficult and can provide heterogeneous results due to the above-mentioned sanitary, geographical, and socioeconomic characteristics. In this issue, an example is provided by the review of Peladic and collaborators [12], which analyzes the literature on the role of probiotics on the modulation of inflammaging. The authors report heterogeneous evidence and come to the conclusion that probiotics have a limited effect on the modulation of low-grade inflammatory conditions in old individuals.


Although research based on the use of experimental models has several hurdles [13], it represents an important resource to study the molecular mechanisms underlying aging, therefore helping in the search for potential targets. The use of these experimental models provides the opportunity to understand the mechanisms of action of micronutrients and to search for dietary regimens or molecules that can ameliorate the signs of aging or that can postpone aging. This Special Issue also provides a contribution to the broad field of antiaging strategies that have been tested in experimental models. Shen and collaborators show that attano-extracted tocotrienols improve the inflammatory and oxidative condition and the metabolism of macronutrients in obese mice [14]. Markovics and collaborators report that the anthocyanin-rich extract of sour cherry can improve the hyperglycemia-induced dysfunction of the endothelium in cultured human umbilical cord vein endothelial cells [15]. Martin and collaborators show that calorie restriction prevents the changes in the hypothalamic neuropeptides that are associated with obesity and metabolic dysregulation in rats [16].


In line with the sentence reported on the Pan American Health organization website, “Healthy aging is a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course”

 (https://www.paho.org/en/healthy-aging (accessed on 20 December 2021)), prevention will have a central role in limiting age-related consequences. In this regard, 

Ottolini and collaborators [17] stress the influence of milk quality for feeding premature neonates on neurodevelopment. Additionally, as reported in the study protocol by 

Mohd Suffian and collaborators [18], there is an increasing interest in interventions aimed at promoting the prevention of frailty.



Monday, May 12, 2025

मधुमेही पाऊल (डायबेटिक फूट)


मधुमेही पायांचा आजार हा एक सामान्य आणि विनाशकारी आहे

मधुमेह समस्या

मधुमेहाच्या पायाचे अल्सरेशन दरवर्षी २.२% असते,

तर मधुमेह असलेल्या लोकांमध्ये पायाचे अल्सरेशन होण्याचा आयुष्यभर धोका ३४% पर्यंत पोहोचतो (१).

दुर्दैवाने, जखमा यशस्वीरित्या बरे झाल्यानंतरही,

मधुमेहाच्या पायाचे अल्सर (DFU Dibetic Foot Ulcer ) चे पुनरावृत्ती दर ४०% पर्यंत पोहोचतात

एका वर्षाच्या आत आणि एपिथेलियलाइज्ड ,(या पेशी आवरण चे काम ज्जाखमेवर

करतात),असे मानण्याचा सल्ला देण्यात आला आहे.

DFU बरे होण्याऐवजी लक्षण विरहित स्थितीत आहे (१).

असा अंदाज आहे की DFU, सहसा संसर्ग किंवा इस्केमियाशी  (रक्त पुरवठा कमी होणे)संबंधित, मधुमेहाशी संबंधित सर्व खालच्या अंगांच्या विच्छेदनांपैकी(amputation ),, सुमारे ७५-८५% आधी होते आणि नॉन-ट्रॉमॅटिक खालच्या अंगाच्या विच्छेदनासाठी(amputation जगभरातील प्रमुख घटक राहतो (२).

 शिवाय, कोरोनरी धमनी रोग, स्ट्रोक किंवा परिधीय धमनी रोग (३) पेक्षा DFU तीव्रता पुढील मृत्युदराचा अधिक महत्त्वाचा अंदाज असल्याचे दिसून येते.

आणि पायाचे व्रण प्रेझेंटेशन नंतर ५० ते ६०% पर्यंत ५ वर्षांच्या जगण्याशी संबंधित आहे (४).

मधुमेही पायाचे व्रण सामान्यतः परिधीय न्यूरोपॅथी आणि/किंवा परिधीय धमनी रोग असलेल्या व्यक्तीमध्ये पायाच्या एखाद्या भागात किरकोळ किंवा पुनरावृत्ती होणाऱ्या दुखापतीमुळे होतात (१).

पायाचे विकृती, DFU किंवा अंगच्छेदनाचा पूर्वीचा इतिहास,

 चारकोट ऑस्टियोआर्थ्रोपॅथी  (nerve ,मुळे हाडाची दुखापत)आणि बदललेल्या बायोमेकॅनिकल लोडिंगमुळे सांधे गतिशीलता कमी होणे हे पायाच्या व्रणांचे इतर प्रमुख जोखीम घटक आहेत (१).

तरीही, जखमेच्या बरे होण्यास विलंब   हा दीर्घकालीन मधुमेही जखमांच्या विकासास कारणीभूत ठरणारा मुख्य घटक मानला जातो (५)

. मधुमेहाच्या जखमेच्या उपचारांचे पॅथोफिजियोलॉजी जटिल, बहुआयामी आहे आणि आतापर्यंत पूर्णपणे समजलेले नाही.

शिवाय, अर्ध्याहून अधिक DFU संक्रमित होतात, ज्यामुळे जखमा बरे होण्याचे प्रमाण आणखी मंदावते आणि पाय कापण्याचा धोका वाढतो (१)




Ref

Editorial Front Endocrinol (Lausanne). 2021 Sep 16;12:753181. doi: 10.3389/fendo.2021.753181


Editorial: Understanding Diabetic Foot Disease: Current Status and Emerging Treatment Approaches


Nikolaos Tentolouris 1,*, Michael E Edmonds 2, Edward B Jude 3, Prashanth R J Vas 2, Chris A Manu 2, Anastasios Tentolouri


s 1, Ioanna Eleftheriad

Sunday, May 11, 2025

Efficacy of hyperbaric oxygen therapy for diabetic foot


Studies have suggested that hyperbaric oxygen therapy (HBOT) is effective in the healing of diabetic foot ulcer (DFU); 

however, there is a lack of consensus. 

Studies that evaluated the effect of HBOT on diabetic foot ulcer, complete healing, amputation, adverse events, ulcer reduction area, and mortality rate were included. Of 1984 study records screened, 14 studies (768 participants) including twelve RCTs, and two CCTs were included as per inclusion criteria. 

The results with pooled analysis have shown that HBOT was significantly effective in complete healing of diabetic foot ulcer (OR = 0.29; 95% CI 0.14–0.61; I2 = 62%) 

Globally about 463 million people are living with diabetes, among them, three fourth (76.2%) are living in the middle, and a few (3.13%) are living in low-income countries. The International Diabetes Federation has anticipated the numbers of diabetes patients to raise to 700 million by 2045. Surprisingly, almost half of type-2 diabetes (DM2) adult patients are unaware that they are suffering from this disease. Moreover, 185.8 million undiagnosed diabetes are from middle-income countries1.



Most of the time DM2 remain completely asymptomatic for a long duration and by the time patient diagnoses they develop complications like neuropathy, retinopathy, metabolic disorders, diabetic foot ulcers (DFUs) which are later difficult to treat. 


Diabetic foot ulcer is defined as a presence of ulcer in the lower limb which is associated with neuropathy and/or peripheral arterial disease in a patient with diabetes2. Eventually, DFUs which are infected and multi-drug resistance (MDR), become non-healing and significantly contributes to amputations and mortality, specifically in the developing countries3,4.



Globally, every 30 s, a lower limb is lost, which is a major sequela of diabetes.


 The incidence rate of DFU in diabetes patient is 2%, (9.26 million) 

and this risk increases 17–60% with a previous history 
of DFU in next three years; also, among them, half (4.63 million) of diabetes patients undergo lower limb amputation at some stage of their life1. Additionally, 28–51% DFU patients after the first amputation will have a higher probability of the second amputation in within five years6. Furthermore, a higher rate (28–77%) of mortality was reported between 90 days to 5 years of post-amputation in diabetic patients7,8, as well as reduction of survival rate at five-years were up to 55%, 34.4% after minor and major amputations respectively in diabetes patients with DFU9

Ref

Sci Rep. 2021 Jan 26;11:2189. doi: 10.1038/s41598-021-81886-1


Efficacy of hyperbaric oxygen therapy for diabetic foot ulcer, a systematic review and meta-analysis of controlled clinical trials

Rakesh Sharma 1, Suresh K Sharma 1, Shiv Kumar Mudgal 2, Prasuna Jelly 1,✉, Kalpana Thakur

Saturday, May 10, 2025

Diabbetic Foot complication

   Diabetes Foot Complication 

Diabetes mellitus is a highly prevalent disease globally and contributes to significant morbidity and mortality. 

Morbidity :Suffering

Pathophysiologic :the study of abnormal changes in body functions 

That atre causes of disease processes.
As a consequence of multiple pathophysiologic changes which are associated with diabetes, these patients frequently suffer from foot-related disorders:

Iinfections, ulcerations, and gangrene.

Gangrene :death of body tissue due to serious bacterial infection 


 Approximately half of all amputations occur in diabetic individuals, 

Amputations :Removal of body part such as toe foot finger


usually as a complication of diabetic foot ulcers
. In this retrospective study, we analyzed and characterized a cohort of 69 patients and their diabetes-related foot complications. 

Cohort  : a study of group of people

The main characteristics of our cohort were as follows: older age at diagnosis (mean age 66); higher incidence of diabetes in males; predominantly urban patient population. 

The most frequent complications of the lower extremity were ulcerations and gangrene. 
Moreover, in our study, 35% of patients required surgical reintervention,
 and 27% suffered from complications, 

while 13% required ICU admission.

 However, diabetic foot lesions are preventable via simple interventions which pointedly reduce foot amputations.

 Early identification and the appropriate medical and surgical treatment of the complications associated with diabetic foot disease
 are important because they still remain common, complex and costly.

Ref Int J Environ Res Public Health

. 2022 Dec 23;20(1):187. doi: 10.3390/ijerph20010187.
Diabetic Foot Complications: A Retrospective Cohort Study
Bogdan Stancu 1, Tamás Ilyés 2, Marius Farcas 3, Horațiu Flaviu Coman 4, Bogdan Augustin Chiș 5, Octavian Aurel Andercou 
Editor: Omorogieva Ojo



Understanding diabetic foot disease :Current status


Diabetic foot disease is a common and devastating 

complication of diabetes mellitus. 


Diabetic foot ulceration has an annual incidence of 2.2%, 

while the lifetime risk of developing foot ulceration among people with diabetes reaches up to 34% (1).

 Unfortunately, even after successful wound healing, 

the recurrence rates of diabetic foot ulcers (DFU) reach up to 40%

 within a year and it has been suggested to consider epithelialized 

DFU as being in remission rather than being healed (1).

 It is estimated that DFU, usually in association with infection or ischemia, precede around 75-85% of all diabetes-related lower limb amputations and remain the worldwide leading factor for non-traumatic lower extremity amputations (2).

 

Moreover, DFU severity seems to be a more significant predictor of subsequent mortality than coronary arterial disease, stroke or peripheral arterial disease (3) 

and foot ulceration is associated with a 5-year survival of 50 to 60% after presentation (4).


Diabetic foot ulcers are commonly caused by minor or repetitive trauma on an area of the foot in a person with peripheral neuropathy and/or peripheral arterial disease (1). 

Foot deformities, previous history of DFU or amputation, Charcot osteoarthropathy and reduced joint mobility leading to altered biomechanical loading are other major risk factors of foot ulceration (1).

 Nevertheless, impaired wound healing is considered the main factor the leads to the development of chronic diabetic wounds (5)

. The pathophysiology of diabetic wound healing is complex, multifaceted, and not completely understood so far. 

Moreover, more than half of DFU become infected, which in turn further slows wound healing and increases the risk of foot amputation (1)

Ref

Editorial Front Endocrinol (Lausanne). 2021 Sep 16;12:753181. doi: 10.3389/fendo.2021.753181
Editorial: Understanding Diabetic Foot Disease: Current Status and Emerging Treatment Approaches
Nikolaos Tentolouris 1,*, Michael E Edmonds 2, Edward B Jude 3, Prashanth R J Vas 2, Chris A Manu 2, Anastasios Tentolouris 1, Ioanna Eleftheriadou 1


Monday, May 5, 2025

Diabetic Foot

 Diabetes mellitus is a highly prevalent disease globally and contributes to significant morbidity and mortality.

 As a consequence of multiple pathophysiologic changes which are associated with diabetes, these patients frequently suffer from foot-related disorders: infections, ulcerations, and gangrene. 

Approximately half of all amputations occur in diabetic individuals, usually as a complication of diabetic foot ulcer

The most frequent complications of the lower extremity were ulcerations and gangrene. 

Moreover, in our study, 35% of patients required surgical reintervention, and 27% suffered from complications, while 13% required ICU admission. 

However, diabetic foot lesions are preventable via simple interventions which pointedly reduce foot amputations.

 Early identification and the appropriate medical and surgical treatment of the complications associated with diabetic foot disease are important because they still remain common, complex and costly.


Introduction :

There are more than 463 million people with diabetes mellitus (DM) worldwide [1]. 

These patients are at risk of multiple diabetes-related complications. Specifically, foot problems cause serious morbidity and mortality in these patients. 

Diabetic patients frequently suffer from foot-related disorders such as gangrene, infection and ulcerations. 

DM is a significant risk factor for peripheral artery disease [2,3]. The International Diabetes Federation estimates that 9.1–26.1 million diabetic individuals will develop diabetic foot ulcers (DFUs) every year [4].


 Moreover, type 1 and type 2 diabetics have a lifetime risk of foot ulcers as high as 34 percent [4]. 

Epidemiological data indicate that diabetic patients have a risk of 2.5% per year to develop foot ulcers [5].

 As shown by a population-based cohort study, diabetic foot ulcers are associated with 5% mortality within the first 12 months and 42% percent mortality at 5 years after first occurrence [6].




In the United States, the treatment of the diabetic foot is responsible for approximately 30 percent of the total costs for diabetic patients’ care—an estimated U.S. $ 176 billion in healthcare costs [8]. 



Additionally, about 20% of patients have unhealed diabetic foot lesions at one year after their diagnosis [9],


 and the recurrence rate is approximately 40% at one year [4]. Diabetic foot amputations also carry significant stigma and impact the quality of life of DM patients [10].


Multiple risk factors contribute to the development of DFUs and other foot lesions such as gangrene and lower extremity infections: poor glycemic control; vascular disease; inadequate foot care; neuropathy and the subsequent loss of protective sensation; foot deformity; trauma; diabetes-related compromised immunity and infections [16].

Int J Environ Res Public Health. 2022 Dec 23;20(1):187. doi: 10.3390/ijerph20010187

Diabetic Foot Complications: A Retrospective Cohort Study
Bogdan Stancu 1,*, Tamás Ilyés 2, Marius Farcas 3, Horațiu Flaviu Coman 4, Bogdan Augustin Chiș 5, Octavian Aurel Andercou 1
Editor: Omorogieva Ojo