Tag: diabetic foot ulcers

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Shoe Technology Reduces Risk of Diabetic Foot Ulcers

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Researchers have developed a new shoe insole technology that helps reduce the risk of diabetic foot ulcers, which can lead to hospitalisation and leg, foot or toe amputations. They describe the technology in The International Journal of Lower Extremity Wounds.

“The goal of this innovative insole technology is to mitigate the risk of diabetic foot ulcers by addressing one of their most significant causes: skin and soft tissue breakdown due to repetitive stress on the foot during walking,” said Muthu B.J. Wijesundara, principal research scientist at The University of Texas at Arlington Research Institute (UTARI).

Diabetes can damage the small blood vessels that supply blood to the nerves, leading to poor circulation and foot sores, also called ulcers. About one-third of people with diabetes develop foot ulcers during their lifetime. Those who have foot ulcers often die at younger ages than those without ulcers.

“Although many shoe insoles have been created over the years to try to alleviate the problem of foot ulcers, studies have shown that their success in preventing them is marginal,” Wijesundara said. “We took the research a step further by creating a pressure-alternating shoe insole that works by cyclically relieving pressure from different areas of the foot, thereby providing periods of rest to the soft tissues and improving blood flow. This approach aims to maintain the health of the skin and tissues, thereby reducing the risk of diabetic foot ulcers.”

In an article in the peer-reviewed International Journal of Lower Extremity Wounds, Wijesundara and UTA colleagues Veysel Erel, Aida Nasirian and Yixin Gu, along with Larry Lavery of UT Southwestern Medical Center, described their innovative insole technology. After this successful pilot project, the next step for the research team will be refining the technology to make it more accessible for users with varying weights and shoe sizes.

“Considering the impact of foot ulcers, it’s exciting that we may be able to make a real difference in the lives of so many people,” Wijesundara said.

Source: University of Texas at Arlington

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Restoring Crucial Enzyme could Supercharge Chronic Wound Healing

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Photo by Diana Polekhina on Unsplash

Scientists have uncovered a key step in the wound healing process that becomes disabled in diseases like diabetes and ageing. Importantly, the research published in Nature reveals a molecule involved in the healing of tissues that leads to a drastic acceleration of wound closure, up to 2.5 times faster, and 1.6 times more muscle regeneration.

The immune system has a critical role in orchestrating tissue healing. As a result, regenerative strategies that control immune components have proved effective. This is particularly relevant when immune dysregulation that results from conditions such as diabetes or advanced age impairs tissue healing following injury. Nociceptive sensory neurons have a crucial role as immunoregulators and exert both protective and harmful effects depending on the context. However, how neuro–immune interactions affect tissue repair and regeneration following acute injury was unclear.

Lead researcher, Associate Professor Mikaël Martino, from Monash University’s Australian Regenerative Medicine Institute (ARMI) in Melbourne, Australia, said the discovery “could transform regenerative medicine, because it sheds light on the crucial role of sensory neurons in orchestrating the repair and regeneration of tissues, offering promising implications for improving patient outcomes.”

The cost of managing poorly healing wounds costs around $250 billion a year.

“In adults with diabetes alone – where poor blood flow can lead to quickly worsening wounds that are often very slow or impossible to heal – the lifetime risk of developing a diabetic foot ulcer (DFU), the most common diabetes-related wound, is 20 to 35 per cent and this number is rising with increased longevity and medical complexity of people with diabetes,” co-lead author, ARMI’s Dr Yen-Zhen Lu said.

Nociceptive sensory neurons, also called nociceptors, are the nerves in our body that sense pain.

These neurons alert us to potentially damaging stimuli in tissues by detecting dangers like tissue damage, inflammation, extremes in temperature, and pressure.

The researchers discovered that, during the healing process, sensory neuron endings grow into injured skin and muscle tissues, communicating with immune cells through a neuropeptide called calcitonin gene-related peptide (CGRP).

“Remarkably, this neuropeptide acts on immune cells to control them, facilitating tissue healing after injury,” Associate Professor Martino said.

Importantly they found that sensory neurons are crucial to the dissemination of CGRP because they showed that the selective removal of sensory neurons in mice reduce CGRP and significantly impairs skin wound healing and muscle regeneration following injury.

When the scientists administered an engineered version of CGRP to mice with neuropathy similar to that seen in diabetic patients, it led to rapid wound healing and muscle regeneration.

According to Associate Professor Martino, these findings hold significant promise for regenerative medicine, particularly for the treatment of poorly-healing tissues and chronic wounds.

“By harnessing neuro-immune interactions, the team aims to develop innovative therapies that address one of the root causes of impaired tissue healing, offering hope to millions,” he said.

“This study has uncovered significant implications for advancing our understanding of the tissue healing process after acute injury. Harnessing the potential of this neuro-immuno-regenerative axis opens new avenues for effective therapies, whether as standalone treatments or in combination with existing therapeutic approaches. “

Source: Monash University

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Responsive Footwear Technology for Diabetic Ulcers

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Image source: Pixabay CC0

To prevent diabetic foot ulcers, scientists at the University of Texas at Arlington have developed responsive footwear technology that relieves pressure on areas of the feet that experience high stress during walking and other activities.

Principal research scientist Muthu Wijesundara and his team have received a patent for a dual-layer insole apparatus for diabetic foot lesion prevention.

Due to numbness in their legs and feet, people with diabetes often are unable to detect and respond to stress-related pain by adjusting their foot loading. This can result in repeated stress to high-pressure foot regions such as the heel or toes and can worsen blisters, sores and ulcers to the point of severe tissue loss or life-threatening infection. For many, foot ulcers can lead to amputation of a toe, foot or leg.

“Diabetes is a leading cause of amputation worldwide, and there is a major role that technology can play to prevent its devastating effects,” Wijesundara said. “We are now one step closer to finding a solution to reduce risk of complications related to diabetic foot ulcers.”

The removable shoe insole relieves stress by periodically regulating and redistributing pressure across all areas of the foot. Using fluid-filled cells, the dual-layer apparatus provides variability in a person’s foot-loading patterns to reduce prolonged pressure to any given area. The insole can automatically adjust and is designed to accommodate people of various weights.

Additionally, the insole can be substituted for a total contact cast during the healing of a foot ulcer, and it can provide gait and ground force analysis.

Source: University of Texas Arlington

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An Oxygen-delivering Hydrogel for Diabetic Foot Ulcers

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Photo by Denes Kozma on Unsplash

A quarter of people with diabetes develop foot ulcers, which are slow to heal due to hypoxic conditions in the wound from impaired blood vessels and increased inflammation. These wounds can become chronic, leading to poor quality of life and possibly amputation.

Jianjun Guan, professor of mechanical engineering and materials science at the McKelvey School of Engineering at Washington University in St. Louis, has developed a hydrogel that delivers oxygen to a wound and decreases inflammation, helps to remodel tissue and speeds up healing. The results are published in Science Advances. 

Prof Guan’s new hydrogel uses microspheres to gradually release oxygen to interact with the cells by means of an enzyme coating that converts the microsphere’s contents into oxygen. In this way, the hydrogel delivers oxygen over two weeks, reducing inflammation and promoting healing.
“The oxygen has two roles: one, to improve skin cell survival under the low-oxygen condition of the diabetic wound; and two, oxygen can stimulate the skin cells to produce growth factors necessary for wound repair,” Prof Guan said.

Source: Washington University in St. Louis