The burden of non-communicable chronic diseases, such as hypertension and diabetes, increases in sub-Saharan Africa. However, the majority of the rural population does still not have access to adequate care. The objective of this study is to examine the effectiveness of integrating care for hypertension and type 2 diabetes by ...

ABSTRACT: The nationwide German disease management program (DMP) for type 2 diabetes was introduced in 2003. Meanwhile, results from evaluation studies were published, but possible baseline differences between DMP and usual-care patients have not been examined. The objective of our study was therefore to find out if patient characteristics as ...

Evaluation of metabolic control of diabetic people has been classically performed measuring glucose concentrations in blood samples. Due to the potential improvement it offers in diabetes care, continuous glucose monitoring (CGM) in the subcutaneous tissue is gaining popularity among both patients and physicians. However, devices for CGM measure glucose concentration ...

To investigate the prevalence of undiagnosed type 2 diabetes (T2D) at primary health care (PHC) clinics, and to assess the quality of care of diabetic patients followed at a tertiary hospital diabetes center in Abu Dhabi, United Arab Emirates (UAE). Between May 2009 and October 2010, adult patients attending two ...

This cross-sectional study sought to establish the level of knowledge of diabetes among community members in rural and urban setups in Kenya and determine how this impacts on their attitude and practices towards diabetes. A face-to-face interview was done for selected respondents using a structured questionnaire for data collection. 1982 ...

To assess the cost-effectiveness of two treatments (medical treatment and amputation) in patients with diabetic foot syndrome, one of the most disabling diabetic complications. Diabetes mellitus is a massive health care problem worldwide with a current prevalence of 150 millions diabetic cases, estimated to increase to 300 million cases in ...

Insulin has been demonstrated to accelerate skin wound healing; however, its effects on wound metabolism have not been adequately studied. Adult rabbits were prepared by creation of skin donor site wound on the back, catheterization of the carotid artery and jugular vein, and placement of a nasogastric feeding tube under ...

Diabetic cardiomyopathy may be accompanied by myocardial fibrosis. We have previously reported that cardiac fibrosis and protein O-glycosylation are elevated in diabetes. In this study, we examined if the hexosamine biosynthesis pathway (HBP) was involved with collagen expression in rat cardiac fibroblasts (RCFs). Long-term glucose load significantly increased type III ...

Until recently, stress hyperglycemia was considered to be a beneficial adaptive response, with raised blood glucose providing a ready source of fuel for the brain, skeletal muscle, heart and other vital organs at a time of increased metabolic demand. Following the Leuven Intensive Insulin Therapy Trial in 2001, tight glycemic ...

AIMS/HYPOTHESIS: Chronic non-healing wounds are a common complication of diabetes. Prolonged inflammation and decreased matrix accumulation may contribute. Connective tissue growth factor (CTGF) is induced during normal wound healing, but its regulation in diabetic wounds is unknown. We developed a primate model for the study of in vivo wound healing ...

Purpose. Diabetic corneas display altered basement membrane and integrin markers, increased expression of proteinases, decreased hepatocyte growth factor (HGF) receptor, c-met proto-oncogene, and impaired wound healing. Recombinant adenovirus (rAV)-driven c-met overexpression in human organ-cultured corneas was tested for correction of diabetic abnormalities. Methods. Forty-six human corneas obtained postmortem from 23 ...

BACKGROUND: Treatment of ingrown toenails using chemical matricectomy in patients with diabetes has been difficult, because delayed wound healing, wound infections, and digital ischemia can interfere with the procedure. Chemical matricectomy with 10% sodium hydroxide is an effective treatment for ingrown toenails in a normal population. OBJECTIVES: Investigation of the ...

A pilot human study is conducted to evaluate the potential of using diffuse photon density wave (DPDW) methodology at near-infrared (NIR) wavelengths (685 to 830 nm) to monitor changes in tissue hemoglobin concentration in diabetic foot ulcers. Hemoglobin concentration is measured by DPDW in 12 human wounds for a period ...

BACKGROUND: We investigated the mechanism of delayed would healing caused by diabetes and measured the dynamic changes in matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) levels. We noted differences in the ratio of MMP-9 to TIMP-1 in the wounds of diabetic and nondiabetic rats. METHODS: Forty-two ...

In spite of a strong physiological rationale, diabetes mellitus as a factor causing increased incidence of wound complications in surgical wounds is not entirely supported by literature. How tight should be the peri-operative blood glucose control remains a controversy. This study describes the experience in patients with clean and clean ...

Collagen-linked fluorescence at excitation/emission 370/440 nm has widely been used as a marker for advanced glycation in studies of aging, diabetic complications, and end-stage renal disease (ESRD). Diagnostic devices measuring skin autofluorescence at this wavelength revealed an association between fluorescence and cardiovascular morbidity and mortality. We now report the presence ...

The interaction between neuropeptides and cytokines and its role in cutaneous wound healing is becoming evident. The goal of the present study is to investigate the impact of diabetes on peripheral cytokine and neuropeptide expression and its role in diabetic wound healing. To achieve this goal, the effect of diabetes ...

Our previous data suggested the involvement of matrix metalloproteinase-10 (MMP-10) and cathepsin F (CTSF) in the basement membrane and integrin changes occurring in diabetic corneas. These markers were now examined in normal human organ-cultured corneas upon recombinant adenovirus (rAV)-driven transduction of MMP-10 and CTSF genes. Fifteen pairs of normal autopsy ...

BACKGROUND: Chronic ulceration, especially in diabetes, remains a substantial clinical problem. Exogenous granulocyte-macrophage colony-stimulating factor (GM-CSF) is efficacious in the treatment of chronic wound healing in both animal models and patients, but its role in diabetic wounds remains to be explored. Objectives Using a diabetic mouse model, to investigate the ...

An early feature of diabetic nephropathy is the alteration of the glomerular basement membrane (GBM), which may result in microalbuminuria, subsequent macroproteinuria, and eventual chronic renal failure. Although type IV collagen is the main component of thickened GBM in diabetic nephropathy, cellular metabolism of each alpha chains of type IV ...

BACKGROUND: Currently, it is reported that statins may be useful in the treatment of diabetes mellitus foot ulceration. The aim of this study was to evaluate treatment of the wounds in streptozotocin-induced diabetic rats with local atorvastatin. METHODS: Two 15 x 15 mm-sized wounds were created in 28 streptozotocin-induced rats. ...

Wound healing is delayed in diabetic patients. We developed a diabetic-porcine burn model and compared the healing of partial-thickness burns in normal and diabetic pigs. We hypothesized that wound healing would be delayed in the diabetic swine. Diabetes mellitus was chemically induced in three domestic pigs (25-50 kg) by intravenous ...

HYPOTHESIS: Impaired wound healing in diabetics is due to pathologic angiogenesis, which is a result of aberrant sphingosine-1-phosphate signaling. Pharmacologic modulation of sphingosine-1-phosphate-dependent signaling normalizes healing in diabetic wounds.

The main pathological condition in patients with impaired wound healing is diabetes mellitus. These patients have significantly low circulating nitric oxide (NO) levels because the stimulatory action of insulin on NO synthesis is absent. Additionally, asymmetric dimethylarginine (ADMA), an inhibitor of NO synthase, is increased owing to the generation of ...

Complex diabetic ulcers of the lower extremity can be slow to heal and may lead to amputation. A retrospective study was conducted to evaluate the effect of a form of electrical stimulation using high-voltage, pulsed current (HVPC) as an adjunct to a multidisciplinary approach to limb salvage for chronic diabetic ...

BACKGROUND AND OBJECTIVE: Impaired wound healing is a complication of diabetes and is a serious problem in clinical practice. The purpose of this study was to evaluate the effect of biostimulation on wound healing in diabetic rats. MATERIAL AND METHODS: Thirty-six female Wistar rats weighting 250 to 300 g were ...

Although the literature contains evidence demonstrating the beneficial effects of insulin on wound healing, no suitable method for the routine administration of insulin has been reported. A randomized, double-blind, placebo-controlled trial was conducted to determine the safety and efficacy of topical insulin on healing in 45 patients (29 men, mean ...

BACKGROUND: Diabetes is a condition known even in its early stages to impair the normal course of wound healing, thus leading to chronic wounds. The role of insulin in the regulation of energy metabolism, protein synthesis, cell differentiation and growth suggests that this hormone could also play an essential role ...

Impaired wound healing is an important diabetic complication associated with increased morbidity and mortality. It appears to be the net result of micro- and macrovascular disease. Diabetic neuropathy and the resulting loss of protective sensation (LOPS) has been recognized as one of the major causes for delayed healing in diabetic ...

Sonic hedgehog (SHH) plays an important role in postnatal tissue repair. The present study tested the hypothesis that impaired SHH pathway results in delayed wound healing by suppressing cutaneous nitric oxide (NO) function in type 1 diabetes. Adult male C57/B6 mice and streptozotocin (STZ)-induced type 1 diabetic mice were used. ...

PURPOSE: Differences in corneal viscoelasticity due to diabetes have been reported to have a protective effect on the progression of glaucoma and the development and progression of keratoconus. Due to longterm changes of tissue in diabetes mellitus, biomechanical changes of the cornea because of glycation and modified extracellular matrix may ...

Although osteomyelitis is a difficult problem, certain conditions make it even more difficult to address. Diabetes, peripheral vascular disease, and radiation are all comorbidities that interfere with wound healing and therefore make the treatment of osteomyelitis challenging. In this article, we discuss these conditions, their pathophysiology, and highlight the special ...

OBJECTIVE: Key features of diabetic nephropathy include the accumulation of extracellular matrix proteins. In recent studies, increased expression of type VIII collagen in the glomeruli and tubulointerstitium of diabetic kidneys has been noted. The objectives of this study were to assess whether type VIII collagen affects the development of diabetic ...

The number of patients requiring dialysis because of diabetes mellitus is increasing and such patients often have complex chronic wounds, which are difficult to heal. However, there are few retrospective studies of wounds requiring surgical treatment. We evaluated 14 patients receiving hemodialysis (HD) (8 because of diabetes and 6 because ...

OBJECTIVE: This study was designed to assess and compare the efficacy of accelerating burn healing in diabetic rats using low-power visible and invisible lasers. Background Data: Low-level laser therapy (LLLT) has been used in a number of diabetic animal and human studies, with both positive and no effects. MATERIALS AND ...

BACKGROUND: This study was designed to elucidate the in vivo efficacy of epidermal growth factor (EGF) on wound healing in non diabetic and diabetic rats. METHODS: Ninety-six male Wistar-Albino rats were randomly divided into six groups. Saline-moistened gauze, pure gelatin or EGF in gelatin-microsphere dressings were used in a dermal ...

Sympathetic nerve failure has been proposed as a contributing factor in impaired cutaneous wound healing in diabetes mellitus. Nevertheless, no studies have shown whether beta-adrenoceptor blockade through beta-blocker (e.g., propranolol) administration may alter healing of diabetic cutaneous lesions. This study evaluated macro- and microscopically the effects of propranolol administration on ...

BACKGROUND: Diabetes mellitus (DM) is characterized by impaired insulin signalling, elevated plasma glucose, and predisposition towards complications involving several organs. A major complication of DM is impairment of wound healing. In the re-epithelialization process during wound healing, migration of keratinocytes is a crucial step. Our previous report demonstrated that keratinocytes ...

The objective of this work was initially to investigate the effects on skin wound healing process by local injection of HSP47 recombinant plasmid in an alloxan-induced diabetic rat model and assess the possibility and utility of gene therapy based on HSP47 plasmid to improve the diabetic skin wound healing. Rats ...

This study was conducted to determine self-care practices and diabetes related emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania. A cross sectional survey-involving 121 Types 2 diabetics was conducted in 4 diabetic clinics located in Dar es Salaam. Anthropometric and biomedical measurements namely weight, ...

BACKGROUND: Impaired wound healing in diabetes has been associated with abnormalities in wound nitric oxide (NO) and nitric oxide synthase (NOS) availability. Efforts to alter the profile of NO expression in the wound microenvironment have proven to be successful in partially restoring wound healing deficits. We investigated the effects of ...

Patients with diabetes are at an increased risk for developing corneal complications and delayed wound healing. This study investigated the effects of high glucose on epidermal growth factor receptor (EGFR) signaling and on epithelial wound healing in the cornea. Effects of high glucose on wound healing and on EGFR signaling ...

The objective was to determine the changes of articular cartilage of the knee joint during immobilization in a rat model. The knee joints of adult male rats were immobilized at 150 degrees of flexion using an internal fixator for 3 days, and 1, 2, 4, 8, and 16 weeks. The ...

OBJECTIVE: We have determined optimal laser dosimetric parameters in comparison with polychromatic light-emitting diodes (LEDs) that can speed up healing in four animal models: non-diabetic oval full-thickness wounds, diabetic oval full-thickness wounds, non-diabetic burns, and diabetic burns in Sprague-Dawley rats. MATERIALS AND METHODS: This series of studies used 532-, 633-, ...

OBJECTIVES: Tendon abnormalities, such as increased stiffness, thickness, and excess calcification, occur commonly in patients with diabetes mellitus and cause considerable disability. These changes are frequently attributed to increased cross-linking of extracellular matrix components by advanced glycation end-products (AGEs). However, cellular effects of AGEs, such as increased activity of the ...

Dermal accumulation of advanced glycation end products (AGEs) has increasingly been implicated as the underlying cause of delayed diabetic wound healing. Devising an in vitro model to adequately mimic glycated tissues will facilitate investigation into the mechanism of glycation in conjunction with exploration of new approaches or improvement of current ...

Diabetic nephropathy, one of the microvascular complications of diabetes mellitus, is a leading cause of end-stage renal disease. Berberine is one of the main constituents of Coptidis Rhizoma and Cortex Phellodendri. In this study, we investigated the effects of berberine on fibronectin and collagen production, and explored the role of ...

Currently, autografts are the best treatment to any substantial cutaneous injury, and their success is well known as a burn therapy. However, autografts have been less successful in the treatment of chronic ulcers, and are usually a last-resort therapy because of infection at the injured site, high surgical expense, additional ...

CONTEXT: Complications from diabetes mellitus affecting the lower limbs occur in 40 to 70% of such patients. Neuropathy is the main cause of ulceration and may be associated with vascular impairment. The wound evolves with necrosis and infection, and if not properly treated, amputation may be the end result. Surgical ...

BACKGROUND/AIMS: Plasminogen activator inhibitor (PAI)-1 is increasingly recognized as a profibrotic factor but the mechanisms are not entirely clear. The present study examined the profibrotic mechanism of PAI-1 focusing on its effect on transforming growth factor (TGF)-beta1 in experimental diabetes. METHODS: PAI-1 knockout (KO) mesangial cells cultured under high glucose ...