By Gautam Wankhede
Diabetes, a chronic condition affecting millions worldwide, can lead to a wide range of health complications. Globally, about 422 million people worldwide have diabetes and 1.5 million deaths are directly attributed to diabetes each year, according to WHO. In India, currently close to 80 million people have diabetes and this number is expected to increase to 135 million by 2045.
While Diabetes can often be managed with lifestyle changes, medication, and insulin, uncontrolled or poorly managed diabetes can lead to a range of complications including heart disease, chronic kidney disease, nerve damage, and other problems with feet, oral health, vision, hearing, and mental health. Among these complications, diabetic foot ulcers are particularly concerning. These ulcers can develop due to neuropathy and vascular issues associated with diabetes and affects 25% of people with diabetes. The annual incidence of diabetic foot ulcer worldwide is between 9.1 to 26.1 million.
Infection of diabetic foot ulcers (DFU) represents a major cause of morbidity and diabetes-related hospital admissions, as well as one of the major pathways to lower limb amputation. Of the one million people who undergo nontraumatic leg amputations annually worldwide, 75% are performed on people who have type 2 diabetes mellitus. In addition, the treatment of DFU is costly. The cost of diagnosis, regular and periodic check-ups, the continuous use of expensive medications, and proper healthcare, including the maintenance of personal hygiene to avoid further deterioration of a DFU condition, leads to a more significant financial burden on the patient.
Diagnosing DFU in their early stages is critical for preventing severe infections and amputations.
Understanding Diabetes Foot Ulcers:
Diabetes foot ulcers are slow-healing wounds that predominantly affect the lower extremities of individuals with diabetes. The underlying causes are multifaceted, with neuropathy (nerve damage) and peripheral arterial disease (poor blood circulation) playing pivotal roles. These factors hinder wound healing, making patients susceptible to infections, tissue damage, and the potential need for amputation.
Diabetes foot ulcers are vulnerable to infection. These infections can spread rapidly and may lead to serious health issues, including cellulitis and osteomyelitis. Bacterial interactions on the skin surface are important in the pathophysiology of DFU and may contribute to a delay in healing. Better defining skin microbiota is essential for understanding the host–bacterial interactions that lead to clinical evidence of infection and problems with wound healing. Another emerging problem is that of antimicrobial resistance (AMR), that is the inability of commonly used antibiotics to act on these pathogens. It is important that the pattern of AMR is identified, information dispersed among the community so inappropriate use of antibiotics can be controlled.
Almost 50–80% of diabetic foot infections are inevitable. But proper footcare (washing, using anti-microbial cream when injured, use of TT, foot massage), diabetic control from hyperglycaemic condition, and monthly or quarterly check-up for diabetic patients are useful in preventing DFU.
Methods for Diagnosing Diabetes Foot Ulcers:
Early diagnosis of diabetes foot ulcers relies on vigilant monitoring and regular check-ups. In recent years, molecular diagnostics have emerged as a promising tool for the early and accurate assessment of diabetes foot ulcers.
The Molecular Diagnostics Advantage:
Traditional methods of diagnosing and monitoring diabetes foot ulcers, such as visual inspections and wound cultures, have limitations when it comes to early detection and comprehensive assessment. Molecular diagnostics offer a range of benefits that are reshaping ulcer management:
Molecular diagnostics enable the identification of biomarkers and genetic indicators associated with diabetes foot ulcers long before visible symptoms appear. This early detection allows healthcare providers to intervene at a stage where treatments are more effective. Further, it helps in the rapid identification of infection-causing microorganisms, which enables the administration of precise antibiotics, reducing the risk of antimicrobial resistance and promoting faster healing. Molecular diagnostics can also predict the likelihood of an ulcer worsening or not responding to conventional treatments, allowing healthcare providers to make informed decisions.
The Future of Diabetes Foot Ulcer Management:
As molecular diagnostics continue to advance, they are becoming an integral part of the multidisciplinary approach to diabetes foot ulcer care. This technology empowers healthcare professionals to act proactively, with the potential to prevent ulcers from developing in the first place. Early intervention, driven by molecular insights, has the potential to reduce the incidence of infections, amputations, and other severe complications associated with these ulcers. Recently, Mylab Discovery Solutions in partnership with UK-based firm DnaNudge have begun developing a diabetic foot ulcer detection kit – next-generation molecular diagnostic solutions for early identification of microbial flora in ulcers, assisting clinicians in planning effective antimicrobial therapy.
Conclusion:
Diabetes foot ulcers are a significant burden for individuals with diabetes, affecting their quality of life and overall health. Molecular diagnostics are transforming the way these ulcers are diagnosed and managed, offering early detection, tailored treatments, and improved patient outcomes. As we continue to unlock the potential of molecular diagnostics, the future holds promise for a world where diabetes-related foot ulcers are effectively prevented and managed, ultimately enhancing the well-being of millions living with this chronic condition.
(The author is a Director-Medical Affairs, Mylab Discovery Solutions. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
