Volume 41 Issue 11
Nov.  2025
Turn off MathJax
Article Contents
Chinese Burn Association,Yangtze River Delta Integrated Diabetic Foot Alliance,Editorial Committee of Chinese Journal of Burns and Wounds.Practical guideline on the prevention and management of diabetic foot in China (Ⅰ)[J].Chin J Burns Wounds,2025,41(11):1029-1049.DOI: 10.3760/cma.j.cn501225-20250801-00345.
Citation: Chinese Burn Association,Yangtze River Delta Integrated Diabetic Foot Alliance,Editorial Committee of Chinese Journal of Burns and Wounds.Practical guideline on the prevention and management of diabetic foot in China (Ⅰ)[J].Chin J Burns Wounds,2025,41(11):1029-1049.DOI: 10.3760/cma.j.cn501225-20250801-00345.

Practical guideline on the prevention and management of diabetic foot in China (Ⅰ)

doi: 10.3760/cma.j.cn501225-20250801-00345
Funds:

2025 Special Government Fund for the Yangtze River Delta Ecological Green Integration Development Demonstration Zone QZHQ[2025]0225

  • Received Date: 2025-08-01
  • Diabetic foot is one of the common and serious complications among the patients with diabetes mellitus. The major causes of amputation and/or death in the patients are foot deformities, ulcers, ischemia, and possible concurrent infections. To further standardize diabetic foot prevention and treatment in China, improve its diagnostic and therapeutic consistency, and promote the development of a specialized tiered care system, Chinese Burn Association, Yangtze River Delta Integrated Diabetic Foot Alliance, and Editorial Committee of Chinese Journal of Burns and Wounds organized a multidisciplinary expert team. The team determined clinical issues related to the diagnosis, treatment, and prevention of diabetic foot and evaluated the quality grades of relevant evidence using the grading of recommendations assessment, development, and evaluation system, and eventually developed the Practical guideline on the prevention and management of diabetic foot in China. There were 46 recommendations formed in the guideline, covering comprehensive medical assessment, internal medical treatments such as control of blood glucose, blood pressure, and blood lipid, antithrombotic and anti-infection therapy, perioperative risk assessment and management, surgical treatments such as debridement, vascular reconstruction, and tissue repair surgeries, as well as foot disease prevention, multidisciplinary team cooperation, and the construction of a tiered care system, aiming to provide guidance for the clinical practice of diabetic foot in China.

     

  • Wang Aiping, Department of Endocrinology, Air Force Hospital of Eastern Theater Command, Nanjing 210002, China, Email: wap454hospital@163.comLiu Yan, Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China, Email: rjliuyan@126.comLuo Gaoxing, Institute of Burn Research, State Key Laboratory of Trauma and Chemical Poisoning, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing Key Laboratory for Wound Repair and Tissue Regeneration, Chongqing 400038, China, Email: logxw@tmmu.edu.cn
  • loading
  • [1]
    McDermottK,FangM,BoultonAJM,et al.Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers[J].Diabetes Care,2023,46(1):209-221.DOI: 10.2337/dci22-0043.
    [2]
    BusSA,van NettenJJ,LaveryLA,et al.IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes[J].Diabetes Metab Res Rev,2016,32Suppl 1:S16-24.DOI: 10.1002/dmrr.2696.
    [3]
    JiangY,WangX,XiaL,et al.A cohort study of diabetic patients and diabetic foot ulceration patients in China[J].Wound Repair Regen,2015,23(2):222-230.DOI: 10.1111/wrr.12263.
    [4]
    ZhangP,LuJ,JingY,et al.Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis [J].Ann Med,2017,49(2):106-116.DOI: 10.1080/07853890.2016.1231932.
    [5]
    BaoX,YangC,FangK,et al.Hospitalization costs and complications in hospitalized patients with type 2 diabetes mellitus in Beijing, China[J].J Diabetes,2017,9(4):405-411.DOI: 10.1111/1753-0407.12428.
    [6]
    LuQ,WangJ,WeiX,et al.Cost of diabetic foot ulcer management in China: a 7-year single-center retrospective review[J].Diabetes Metab Syndr Obes,2020,13:4249-4260.DOI: 10.2147/DMSO.S275814.
    [7]
    ZhangY,LiuH,YangY,et al.Incidence and risk factors for amputation in Chinese patients with diabetic foot ulcers: a systematic review and meta-analysis[J].Front Endocrinol (Lausanne),2024,15:1405301.DOI: 10.3389/fendo.2024.1405301.
    [8]
    ArmstrongDG,BoultonA,BusSA.Diabetic foot ulcers and their recurrence[J].N Engl J Med,2017,376(24):2367-2375.DOI: 10.1056/NEJMra1615439.
    [9]
    WangA,LvG,ChengX,et al.Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition)[J/OL].Burns Trauma,2020,8:tkaa017[2024-08-01].https://pubmed.ncbi.nlm.nih.gov/32685563/. DOI: 10.1093/burnst/tkaa017.
    [10]
    GuyattG,OxmanAD,AklEA,et al.GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables[J].J Clin Epidemiol,2011,64(4):383-394.DOI: 10.1016/j.jclinepi.2010.04.026.
    [11]
    BrouwersMC,KhoME,BrowmanGP,et al.AGREE II: advancing guideline development, reporting and evaluation in health care[J].CMAJ,2010,182(18):E839-842.DOI: 10.1503/cmaj.090449.
    [12]
    ChenY,YangK,MarušicA,et al.A reporting tool for practice guidelines in health care: the RIGHT statement[J].Ann Intern Med,2017,166(2):128-132.DOI: 10.7326/M16-1565.
    [13]
    SheaBJ,ReevesBC,WellsG,et al.AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both[J].BMJ,2017,358:j4008.DOI: 10.1136/bmj.j4008.
    [14]
    HigginsJPT,AltmanDG,GøtzschePC,et al.The Cochrane Collaboration's tool for assessing risk of bias in randomised trials[J].BMJ,2011,343:d5928.DOI: 10.1136/bmj.d5928.
    [15]
    StangA.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J].Eur J Epidemiol,2010,25(9):603-605.DOI: 10.1007/s10654-010-9491-z.
    [16]
    WhitingPF,RutjesAWS,WestwoodME,et al.QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies[J].Ann Intern Med,2011,155(8):529-536.DOI: 10.7326/0003-4819-155-8-201110180-00009.
    [17]
    ArmstrongDG,TanTW,BoultonAJM,et al.Diabetic foot ulcers: a review[J].JAMA,2023,330(1):62-75.DOI: 10.1001/jama.2023.10578.
    [18]
    SchaperNC,van NettenJJ,ApelqvistJ,et al.Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update)[J].Diabetes Metab Res Rev,2024,40(3):e3657.DOI: 10.1002/dmrr.3657.
    [19]
    SennevilleÉ,AlbalawiZ,van AstenSA,et al.IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF/IDSA 2023)[J].Diabetes Metab Res Rev,2024,40(3):e3687.DOI: 10.1002/dmrr.3687.
    [20]
    SennevilleÉ,AlbalawiZ,van AstenSA,et al.Diagnosis of infection in the foot of patients with diabetes: a systematic review[J].Diabetes Metab Res Rev,2024,40(3):e3723.DOI: 10.1002/dmrr.3723.
    [21]
    Van AstenSA,NicholsA,La FontaineJ,et al.The value of inflammatory markers to diagnose and monitor diabetic foot osteomyelitis[J].Int Wound J,2017,14(1):40-45.DOI: 10.1111/iwj.12545.
    [22]
    HuangY,CaoY,ZouM,et al.A comparison of tissue versus swab culturing of infected diabetic foot wounds[J].Int J Endocrinol,2016,2016:8198714.DOI: 10.1155/2016/8198714.
    [23]
    NelsonA,Wright-HughesA,BackhouseMR,et al.CODIFI (concordance in diabetic foot ulcer infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England[J].BMJ Open,2018,8(1):e019437.DOI: 10.1136/bmjopen-2017-019437.
    [24]
    Tardáguila-GarcíaA,García-ÁlvarezY,Sanz-CorbalánI,et al.Could X-ray predict long-term complications in patients with diabetic foot osteomyelitis?[J].Adv Skin Wound Care,2022,35(8):1-5.DOI: 10.1097/01.ASW.0000834460.20632.18.
    [25]
    Calvo-WrightMDM,Álvaro-AfonsoFJ,López-MoralM,et al.Is the combination of plain X-ray and probe-to-bone test useful for diagnosing diabetic foot osteomyelitis? A systematic review and meta-analysis[J].J Clin Med,2023,12(16):5369.DOI: 10.3390/jcm12165369.
    [26]
    XuJ,ChengF,LiY,et al.Erythrocyte sedimentation rate combined with the probe-to-bone test for fast and early diagnosis of diabetic foot osteomyelitis[J].Int J Low Extrem Wounds,2021,20(3):227-231.DOI: 10.1177/1534734620923278.
    [27]
    MoallemiSK,NiroomandM,TadayonN,et al.Diagnostic value of erythrocyte sedimentation rate and C reactive protein in detecting diabetic foot osteomyelitis; a cross-sectional study[J].Arch Acad Emerg Med,2020,8(1):e71.
    [28]
    ChenX,ShenY,WangY,et al.Decreased accuracy of erythrocyte sedimentation rate in diagnosing osteomyelitis in diabetic foot infection patients with severe renal impairment: a retrospective cross-sectional study[J].PLoS One,2022,17(3):e0265769.DOI: 10.1371/journal.pone.0265769.
    [29]
    GrambergMCTT,KnippersC,LagrandRS,et al.Concordance between culture, molecular culture and illumina 16S rRNA gene amplicon sequencing of bone and ulcer bed biopsies in people with diabetic foot osteomyelitis[J].BMC Infect Dis,2023,23(1):505.DOI: 10.1186/s12879-023-08472-w.
    [30]
    SchechterMC,AliMK,RiskBB,et al.Percutaneous bone biopsy for diabetic foot osteomyelitis: a systematic review and meta-analysis[J].Open Forum Infect Dis,2020,7(10):ofaa393.DOI: 10.1093/ofid/ofaa393.
    [31]
    LeoneA,BiancoNC,D'AmbraG,et al.The role of serial radiographs in diagnosing diabetic foot bone osteomyelitis[J].Mediterr J Hematol Infect Dis,2022,14(1):e2022055.DOI: 10.4084/MJHID.2022.055.
    [32]
    JinY,HuangK,ShaoT.[18F]Fluorodeoxyglucose ([18F]FDG) positron emission tomography and conventional imaging modalities in the diagnosis of diabetic foot osteomyelitis: a meta-analysis[J].Clin Radiol,2024,79(9):e1142-e1151.DOI: 10.1016/j.crad.2024.05.015.
    [33]
    FéronF,de PonfillyGP,PotierL,et al.Reliability and safety of bedside blind bone biopsy performed by a diabetologist for the diagnosis and treatment of diabetic foot osteomyelitis[J].Diabetes Care,2021,44(11):2480-2486.DOI: 10.2337/dc20-3170.
    [34]
    WudhikulprapanW,PhinyoP,HadiA,et al.Diagnosing osteomyelitis in diabetic foot by diffusion-weighted imaging and dynamic contrast material-enhanced magnetic resonance imaging: a systematic review and meta-analysis[J].Clin Radiol,2024,79(11):805-817.DOI: 10.1016/j.crad.2024.07.015.
    [35]
    XuJ,ChenW,HeL,et al.Most postoperative reserved "normal" metatarsal stumps of diabetic foot osteomyelitis are infected but have healing potential[J].Front Endocrinol (Lausanne),2023,14:1165305.DOI: 10.3389/fendo.2023.1165305.
    [36]
    TarriconeA,MataK,GeeA,et al.A systematic review and meta-analysis of the effectiveness of LRINEC score for predicting upper and lower extremity necrotizing fasciitis[J].J Foot Ankle Surg,2022,61(2):384-389.DOI: 10.1053/j.jfas.2021.09.015.
    [37]
    MartucciJA,RiemerK.Gas-producing infections in the foot at a large academic medical center: a 10-year retrospective review[J].J Foot Ankle Surg,2023,62(2):360-364.DOI: 10.1053/j.jfas.2022.09.004.
    [38]
    Ozer BalinS,OzcanEC,UğurK.A new inflammatory marker of clinical and diagnostic importance in diabetic foot infection: systemic immune-inflammation index[J].Int J Low Extrem Wounds,2025,24(4):1003-1009.DOI: 10.1177/15347346221130817.
    [39]
    BoultonAJM,ArmstrongDG,AlbertSF,et al.Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists[J].Diabetes Care,2008,31(8):1679-1685.DOI: 10.2337/dc08-9021.
    [40]
    LauriC,LeoneA,CavalliniM,et al.Diabetic foot infections: the diagnostic challenges[J].J Clin Med,2020,9(6):1779.DOI: 10.3390/jcm9061779.
    [41]
    IacopiE,SbarbaroC,PieruzziL,et al.Necrotizing fasciitis and diabetic foot: results of a prompt identification, surgery and antibiotic therapy (P.I.S.A.) protocol[J].Int J Low Extrem Wounds,2023,22(4):733-741.DOI: 10.1177/15347346211041452.
    [42]
    ToschiA,GiannellaM,VialeP.Recurrence of skin and soft tissue infections: identifying risk factors and treatment strategies[J].Curr Opin Infect Dis,2025,38(2):71-77.DOI: 10.1097/QCO.0000000000001096.
    [43]
    ShahAD,LangenbergC,RapsomanikiE,et al.Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1.9 million people[J].Lancet Diabetes Endocrinol,2015,3(2):105-113.DOI: 10.1016/S2213-8587(14)70219-0.
    [44]
    GornikHL,AronowHD,GoodneyPP,et al.2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J].Circulation,2024,149(24):e1313-e1410.DOI: 10.1161/CIR.0000000000001251.
    [45]
    StoberockK,KaschwichM,NicolaySS,et al.The interrelationship between diabetes mellitus and peripheral arterial disease[J].Vasa,2021,50(5):323-330.DOI: 10.1024/0301-1526/a000925.
    [46]
    FitridgeR,ChuterV,MillsJ,et al.The intersocietal IWGDF, ESVS, SVS guidelines on peripheral artery disease in people with diabetes mellitus and a foot ulcer[J].J Vasc Surg,2023,78(5):1101-1131.DOI: 10.1016/j.jvs.2023.07.020.
    [47]
    MazzolaiL,Teixido-TuraG,LanziS,et al.2024 ESC Guidelines for the management of peripheral arterial and aortic diseases[J].Eur Heart J,2024,45(36):3538-3700.DOI: 10.1093/eurheartj/ehae179.
    [48]
    ConteMS,BradburyAW,KolhP,et al.Global vascular guidelines on the management of chronic limb-threatening ischemia[J].J Vasc Surg,2019,69(6S):3S-125S.e40.DOI: 10.1016/j.jvs.2019.02.016.
    [49]
    GrözingerG,PohmannR,SchickF,et al.Perfusion measurements of the calf in patients with peripheral arterial occlusive disease before and after percutaneous transluminal angioplasty using MR arterial spin labeling[J].J Magn Reson Imaging,2014,40(4):980-987.DOI: 10.1002/jmri.24463.
    [50]
    MogilevskayaM,Gaviria-CarrilloM,Feliciano-AlfonsoJE,et al.Diagnostic accuracy of screening tests for diabetic peripheral neuropathy: an umbrella review[J].J Diabetes Res,2024,2024:5902036.DOI: 10.1155/jdr/5902036.
    [51]
    KorstGS,RatliffHT,TorianJ,et al.Delayed diagnosis of Charcot foot: a systematic review[J].J Foot Ankle Surg,2022,61(5):1109-1113.DOI: 10.1053/j.jfas.2022.01.008.
    [52]
    RaspovicKM,SchaperNC,GoodayC,et al.Diagnosis and treatment of active charcot neuro-osteoarthropathy in persons with diabetes mellitus: a systematic review[J].Diabetes Metab Res Rev,2024,40(3):e3653.DOI: 10.1002/dmrr.3653.
    [53]
    WukichDK,SchaperNC,GoodayC,et al.Guidelines on the diagnosis and treatment of active Charcot neuro-osteoarthropathy in persons with diabetes mellitus (IWGDF 2023)[J].Diabetes Metab Res Rev,2024,40(3):e3646.DOI: 10.1002/dmrr.3646.
    [54]
    Monteiro-SoaresM,HamiltonEJ,RussellDA,et al.Guidelines on the classification of foot ulcers in people with diabetes (IWGDF 2023 update)[J].Diabetes Metab Res Rev,2024,40(3):e3648.DOI: 10.1002/dmrr.3648.
    [55]
    Monteiro-SoaresM, HamiltonEJ, RussellDA, et al. Classification of foot ulcers in people with diabetes: a systematic review[J]. Diabetes Metab Res Rev, 2024, 40(3): e3645.DOI: 10.1002/dmrr.3645.
    [56]
    中华医学会糖尿病学分会糖尿病足与周围血管病学组.中国糖尿病足诊治临床路径(2023版)[J].中华内分泌代谢杂志,2023,39(2):93-102.DOI: 10.3760/cma.j.cn311282-20221014-00583.
    [57]
    KörberA,KlodeJ,Al-BennaS,et al.Etiology of chronic leg ulcers in 31,619 patients in Germany analyzed by an expert survey[J].J Dtsch Dermatol Ges,2011,9(2):116-121.DOI: 10.1111/j.1610-0387.2010.07535.x.
    [58]
    KörberA,JockenhöferF,SondermannW,et al.First manifestation of leg ulcers: analysis of data from 1000 patients[J].Hautarzt,2017,68(6):483-491.DOI: 10.1007/s00105-017-3950-3.
    [59]
    DissemondJ,PlackeJM,MoellekenM,et al.The differential diagnosis of leg ulcers[J].Dtsch Arztebl Int,2024,121(22):733-739.DOI: 10.3238/arztebl.m2024.0133.
    [60]
    ProbstS,SainiC,GschwindG,et al.Prevalence and incidence of venous leg ulcers-a systematic review and meta-analysis[J].Int Wound J,2023,20(9):3906-3921.DOI: 10.1111/iwj.14272.
    [61]
    NicoaraM,BainK,PatelR,et al.Malignant transformation of nonhealing ulcer-basal cell carcinoma[J].Ann Vasc Surg,2021,70:565.e7-565.e10.DOI: 10.1016/j.avsg.2020.01.100.
    [62]
    BarbeM,BatraA,GoldingS,et al.Pyoderma gangrenosum: a literature review[J].Clin Podiatr Med Surg,2021,38(4):577-588.DOI: 10.1016/j.cpm.2021.06.002.
    [63]
    Ammad Ud DinM,HussainSA,JamshedS.Leg ulcer with long-term hydroxyurea use[J].Clin Case Rep,2021,9(4):2487-2488.DOI: 10.1002/ccr3.3991.
    [64]
    YanT,DouZ,ClaireM,et al.Risk factors for first-ever diabetes-related foot ulcer: a systematic review and meta-analysis[J].Int Wound J,2025,22(8):e70728.DOI: 10.1111/iwj.70728.
    [65]
    ShinJY,RohSG,SharafB,et al.Risk of major limb amputation in diabetic foot ulcer and accompanying disease: a meta-analysis[J].J Plast Reconstr Aesthet Surg,2017,70(12):1681-1688.DOI: 10.1016/j.bjps.2017.07.015.
    [66]
    XieY,ZhangH,YeT,et al.The geriatric nutritional risk index independently predicts mortality in diabetic foot ulcers patients undergoing amputations[J].J Diabetes Res,2017,2017:5797194.DOI: 10.1155/2017/5797194.
    [67]
    LauwersP,HendriksJMH,Van BouwelS,et al.Malnutrition according to the 2018 GLIM criteria is highly prevalent in people with a diabetic foot ulcer but does not affect outcome[J].Clin Nutr ESPEN,2021,43:335-341.DOI: 10.1016/j.clnesp.2021.03.029.
    [68]
    RodriguesBT,VangavetiVN,UrkudeR,et al.Prevalence and risk factors of lower limb amputations in patients with diabetic foot ulcers: a systematic review and meta-analysis[J].Diabetes Metab Syndr,2022,16(2):102397.DOI: 10.1016/j.dsx.2022.102397.
    [69]
    AuneD,SchlesingerS,NeuenschwanderM,et al.Diabetes mellitus, blood glucose and the risk of heart failure: a systematic review and meta-analysis of prospective studies[J].Nutr Metab Cardiovasc Dis,2018,28(11):1081-1091.DOI: 10.1016/j.numecd.2018.07.005.
    [70]
    LiuC,LiangW,HeX,et al.Prognostic value of cysteine-rich protein 61 combined with N-terminal pro-B-type natriuretic peptide for mortality in acute heart failure patients with and without chronic kidney disease[J].Cardiorenal Med,2020,10(1):11-21.DOI: 10.1159/000501929.
    [71]
    XuL,QianH,GuJ,et al.Heart failure in hospitalized patients with diabetic foot ulcers: clinical characteristics and their relationship with prognosis[J].J Diabetes,2013,5(4):429-438.DOI: 10.1111/1753-0407.12062.
    [72]
    ZakiHA,BashirK,IftikharH,et al.Evaluating the effectiveness of pretreatment with intravenous fluid in reducing the risk of developing contrast-induced nephropathy: a systematic review and meta-analysis[J].Cureus,2022,14(5):e24825.DOI: 10.7759/cureus.24825.
    [73]
    HanXF,ZhangXX,LiuKM,et al.Contrast-induced nephropathy in patients with diabetes mellitus between iso- and low-osmolar contrast media: a meta-analysis of full-text prospective, randomized controlled trials[J].PLoS One,2018,13(3):e0194330.DOI: 10.1371/journal.pone.0194330.
    [74]
    FilimonovRV,FilimonovaIV,ShapovalSD,et al.Comparative analysis of the methods of anesthetic maintenance in patients with diabetes with the syndrome of diabetic foot requiring operative intervention[J].Wiad Lek,2019,72(4):558-561.
    [75]
    LiuW,ZhengS,DuX.Association of systemic immune-inflammation index and systemic inflammation response index with diabetic kidney disease in patients with type 2 diabetes mellitus[J].Diabetes Metab Syndr Obes,2024,17:517-531.DOI: 10.2147/DMSO.S447026.
    [76]
    SmartNA,DiebergG,LadhaniM,et al.Early referral to specialist nephrology services for preventing the progression to end-stage kidney disease[J].Cochrane Database Syst Rev,2014(6):CD007333.DOI: 10.1002/14651858.CD007333.pub2.
    [77]
    JiaY,LongD,YangY,et al.Diabetic peripheral neuropathy and glycemic variability assessed by continuous glucose monitoring: a systematic review and meta-analysis[J].Diabetes Res Clin Pract,2024,213:111757.DOI: 10.1016/j.diabres.2024.111757.
    [78]
    CallaghanBC,LittleAA,FeldmanEL,et al.Enhanced glucose control for preventing and treating diabetic neuropathy[J].Cochrane Database Syst Rev,2012,2012(6):CD007543.DOI: 10.1002/14651858.CD007543.pub2.
    [79]
    LaneKL,AbusamaanMS,VossBF,et al.Glycemic control and diabetic foot ulcer outcomes: a systematic review and meta-analysis of observational studies[J].J Diabetes Complications,2020,34(10):107638.DOI: 10.1016/j.jdiacomp.2020.107638.
    [80]
    LanNSR,DwivediG,FeganPG,et al.Unravelling the cardio-renal-metabolic-foot connection in people with diabetes-related foot ulceration: a narrative review[J].Cardiovasc Diabetol,2024,23(1):437.DOI: 10.1186/s12933-024-02527-1.
    [81]
    WerkmanNCC,DriessenJHM,KlungelOH,et al.Incretin-based therapy and the risk of diabetic foot ulcers and related events[J].Diabetes Obes Metab,2024,26(9):3764-3780.DOI: 10.1111/dom.15721.
    [82]
    MatthewsDR,LiQ,PerkovicV,et al.Effects of canagliflozin on amputation risk in type 2 diabetes: the CANVAS program[J].Diabetologia,2019,62(6):926-938.DOI: 10.1007/s00125-019-4839-8.
    [83]
    HodgsonA,GilliesCL,HightonP,et al.Risk of lower extremity amputation in patients with type 2 diabetes mellitus and peripheral arterial disease receiving sodium-glucose cotransporter-2 inhibitors versus other medications: a systematic review and meta-analysis of observational cohort studies[J].Diabetes Obes Metab,2024,26(6):2487-2491.DOI: 10.1111/dom.15571.
    [84]
    DuY,BaiL,FanB,et al.Effect of SGLT2 inhibitors versus DPP4 inhibitors or GLP-1 agonists on diabetic foot-related extremity amputation in patients with T2DM: a meta-analysis[J].Prim Care Diabetes,2022,16(1):156-161.DOI: 10.1016/j.pcd.2021.12.007.
    [85]
    KhanS,MohammadnezhadM,RatuA,et al.Patterns and risk factors associated with index lower extremity amputations (LEA) among type 2 diabetes mellitus (T2DM) patients in Fiji[J].Prim Care Diabetes,2021,15(6):1012-1018.DOI: 10.1016/j.pcd.2021.07.007.
    [86]
    LiuJ,YuanX,LiuJ,et al.Risk factors for diabetic peripheral neuropathy, peripheral artery disease, and foot deformity among the population with diabetes in Beijing, China: a multicenter, cross-sectional study[J].Front Endocrinol (Lausanne),2022,13:824215.DOI: 10.3389/fendo.2022.824215.
    [87]
    HallströmS,SvenssonAM,PivodicA,et al.Risk factors and incidence over time for lower extremity amputations in people with type 1 diabetes: an observational cohort study of 46,088 patients from the Swedish National Diabetes Registry[J].Diabetologia,2021,64(12):2751-2761.DOI: 10.1007/s00125-021-05550-z.
    [88]
    Gomez-MarinB,Gomez-DelgadoF,Lopez-MorenoJ,et al.Long-term consumption of a Mediterranean diet improves postprandial lipemia in patients with type 2 diabetes: the Cordioprev randomized trial[J].Am J Clin Nutr,2018,108(5):963-970.DOI: 10.1093/ajcn/nqy144.
    [89]
    RajamaniK,ColmanPG,LiLP,et al.Effect of fenofibrate on amputation events in people with type 2 diabetes mellitus (FIELD study): a prespecified analysis of a randomised controlled trial[J].Lancet,2009,373(9677):1780-1788.DOI: 10.1016/S0140-6736(09)60698-X.
    [90]
    TeramotoT,UsamiM,TakagiY,et al.Efficacy and safety of alirocumab in Japanese patients with diabetes mellitus: post-hoc subanalysis of ODYSSEY Japan[J].J Atheroscler Thromb,2019,26(3):282-293.DOI: 10.5551/jat.45070.
    [91]
    ChenY,YuanZ,LuJ,et al.Randomized study of evolocumab in patients with type 2 diabetes and dyslipidaemia on background statin: pre-specified analysis of the Chinese population from the BERSON clinical trial[J].Diabetes Obes Metab,2019,21(6):1464-1473.DOI: 10.1111/dom.13700.
    [92]
    GiuglianoRP,CannonCP,BlazingMA,et al.Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (improved reduction of outcomes: Vytorin efficacy international trial)[J].Circulation,2018,137(15):1571-1582.DOI: 10.1161/CIRCULATIONAHA.117.030950.
    [93]
    GrundySM,StoneNJ,BaileyAL,et al.2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines[J].Circulation,2019,139(25):e1082-e1143.DOI: 10.1161/CIR.0000000000000625.
    [94]
    OyamaK,GiuglianoRP,BlazingMA,et al.Baseline low-density lipoprotein cholesterol and clinical outcomes of combining ezetimibe with statin therapy in IMPROVE-IT[J].J Am Coll Cardiol,2021,78(15):1499-1507.DOI: 10.1016/j.jacc.2021.08.011.
    [95]
    StoneNJ,RobinsonJG,LichtensteinAH,et al.2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2014,63(25Pt B):2889-2934.DOI: 10.1016/j.jacc.2013.11.002.
    [96]
    WilsonPWF,PolonskyTS,MiedemaMD,et al.Systematic review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the manage-ment of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines[J].Circulation,2019,139(25):e1144-e1161.DOI: 10.1161/CIR.0000000000000626.
    [97]
    StegPG,BhattDL,SimonT,et al.Ticagrelor in patients with stable coronary disease and diabetes[J].N Engl J Med,2019,381(14):1309-1320.DOI: 10.1056/NEJMoa1908077.
    [98]
    BonacaMP,BhattDL,SimonT,et al.Limb outcomes with ticagrelor plus aspirin in patients with diabetes mellitus and atherosclerosis[J].J Am Coll Cardiol,2024,83(17):1627-1636.DOI: 10.1016/j.jacc.2024.03.377.
    [99]
    RoffiM,LandiA,HegD,et al.Abbreviated or standard antiplatelet therapy after PCI in diabetic patients at high bleeding risk[J].JACC Cardiovasc Interv,2024,17(22):2664-2677.DOI: 10.1016/j.jcin.2024.08.030.
    [100]
    BhattDL,EikelboomJW,ConnollySJ,et al.Role of combination antiplatelet and anticoagulation therapy in diabetes mellitus and cardiovascular disease: insights from the COMPASS trial[J].Circulation,2020,141(23):1841-1854.DOI: 10.1161/CIRCULATIONAHA.120.046448.
    [101]
    KaplovitchE,EikelboomJW,DyalL,et al.Rivaroxaban and aspirin in patients with symptomatic lower extremity peripheral artery disease: a subanalysis of the COMPASS randomized clinical trial[J].JAMA Cardiol,2021,6(1):21-29.DOI: 10.1001/jamacardio.2020.4390.
    [102]
    Low WangCC,BlomsterJI,HeizerG,et al.Cardiovascular and limb outcomes in patients with diabetes and peripheral artery disease: the EUCLID trial[J].J Am Coll Cardiol,2018,72(25):3274-3284.DOI: 10.1016/j.jacc.2018.09.078.
    [103]
    AjjanRA,KietsirirojeN,BadimonL,et al.Antithrombotic therapy in diabetes: which, when, and for how long?[J].Eur Heart J,2021,42(23):2235-2259.DOI: 10.1093/eurheartj/ehab128.
    [104]
    GuoL,PanQ,ChengZ,et al.Acetyllevocarnitine hydrochloride for the treatment of diabetic peripheral neuropathy: a phase 3 randomized clinical trial in China[J].Diabetes,2024,73(5):797-805.DOI: 10.2337/db23-0377.
    [105]
    RanGL,LiYP,LuLC,et al.Disease-modifying therapies for diabetic peripheral neuropathy: a systematic review and meta-analysis of randomized controlled trials[J].J Diabetes Complications,2024,38(2):108691.DOI: 10.1016/j.jdiacomp.2024.108691.
    [106]
    WuCS,HuangYJ,KoYC,et al.Efficacy and safety of duloxetine in painful diabetic peripheral neuropathy: a systematic review and meta-analysis of randomized controlled trials[J].Syst Rev,2023,12(1):53.DOI: 10.1186/s13643-023-02185-6.
    [107]
    PonirakisG,Abdul-GhaniMA,JayyousiA,et al.Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control[J].J Diabetes Investig,2021,12(9):1642-1650.DOI: 10.1111/jdi.13544.
    [108]
    FuQ,YangH,ZhangL,et al.Traditional Chinese medicine foot bath combined with acupoint massage for the treatment of diabetic peripheral neuropathy: a systematic review and meta-analysis of 31 RCTs[J].Diabetes Metab Res Rev,2020,36(2):e3218.DOI: 10.1002/dmrr.3218.
    [109]
    AlizadehSD,JahaniS,RukerdMRZ,et al.Human studies of the efficacy and safety of stem cells in the treatment of diabetic peripheral neuropathy: a systematic review and meta-analysis[J].Stem Cell Res Ther,2024,15(1):442.DOI: 10.1186/s13287-024-04033-3.
    [110]
    AnjuM,Ummer VelladathS,Arun MaiyaG,et al.A single blinded randomized controlled trial assessing the effect of photobiomodulation therapy on neuron specific biomarkers in type II diabetes mellitus patients with peripheral neuropathy[J].Diabetes Res Clin Pract,2025,222:112087.DOI: 10.1016/j.diabres.2025.112087.
    [111]
    TatikolaSP,NatarajanV,DesaiVK,et al.Effect of various exercise protocols on neuropathic pain in individuals with type 2 diabetes with peripheral neuropathy: a systematic review and meta-analysis[J].Diabetes Metab Syndr,2022,16(9):102603.DOI: 10.1016/j.dsx.2022.102603.
    [112]
    van NootenF,TreurM,PantiriK,et al.Capsaicin 8% patch versus oral neuropathic pain medications for the treatment of painful diabetic peripheral neuropathy: a systematic literature review and network meta-analysis[J].Clin Ther,2017,39(4):787-803.e18.DOI: 10.1016/j.clinthera.2017.02.010.
    [113]
    HaanpääM,CruccuG,NurmikkoTJ,et al.Capsaicin 8% patch versus oral pregabalin in patients with peripheral neuropathic pain[J].Eur J Pain,2016,20(2):316-328.DOI: 10.1002/ejp.731.
    [114]
    CruccuG,NurmikkoTJ,ErnaultE,et al.Superiority of capsaicin 8% patch versus oral pregabalin on dynamic mechanical allodynia in patients with peripheral neuropathic pain[J].Eur J Pain,2018,22(4):700-706.DOI: 10.1002/ejp.1155.
    [115]
    HussainN,SaidASA,JavaidFA,et al.The efficacy and safety profile of capsaicin 8% patch versus 5% lidocaine patch in patients with diabetic peripheral neuropathic pain: a randomized, placebo-controlled study of south Asian male patients[J].J Diabetes Metab Disord,2021,20(1):271-278.DOI: 10.1007/s40200-021-00741-2.
    [116]
    AkahoriH,TakamuraT,HayakawaT,et al.Prostaglandin E1 in lipid microspheres ameliorates diabetic peripheral neuropathy: clinical usefulness of Semmes-Weinstein monofilaments for evaluating diabetic sensory abnormality[J].Diabetes Res Clin Pract,2004,64(3):153-159.DOI: 10.1016/j.diabres.2003.10.012.
    [117]
    EisenbergE,McNicolED,CarrDB.Efficacy of mu-opioid agonists in the treatment of evoked neuropathic pain: systematic review of randomized controlled trials[J].Eur J Pain,2006,10(8):667-676.DOI: 10.1016/j.ejpain.2005.10.007.
    [118]
    ArdeleanuV,TomaA,PafiliK,et al.Current pharmacological treatment of painful diabetic neuropathy: a narrative review[J].Medicina (Kaunas),2020,56(1):25.DOI: 10.3390/medicina56010025.
    [119]
    PetersenEA,StaussTG,ScowcroftJA,et al.Effect of high-frequency (10-kHz) spinal cord stimulation in patients with painful diabetic neuropathy: a randomized clinical trial[J].JAMA Neurol,2021,78(6):687-698.DOI: 10.1001/jamaneurol.2021.0538.
    [120]
    PetersenEA,StaussTG,ScowcroftJA,et al.Long-term efficacy of high-frequency (10 kHz) spinal cord stimulation for the treatment of painful diabetic neuropathy: 24-month results of a randomized controlled trial[J].Diabetes Res Clin Pract,2023,203:110865.DOI: 10.1016/j.diabres.2023.110865.
    [121]
    ZhouPB,SunHT,BaoM.Comparative analysis of the efficacy of spinal cord stimulation and traditional debridement care in the treatment of ischemic diabetic foot ulcers: a retrospective cohort study[J].Neurosurgery,2024,95(2):313-321.DOI: 10.1227/neu.0000000000002866.
    [122]
    YaoXC,LiuJP,XuZY,et al.Short-term spinal cord stimulation versus debridement for the treatment of diabetic foot: a retrospective cohort study[J].Asian J Surg,2024:S1015-9584(24)02375-02373.DOI: 10.1016/j.asjsur.2024.10.065.
    [123]
    ChenJL,HesseltineAW,NashiSE,et al.A real-world analysis of high-frequency 10 kHz spinal cord stimulation for the treatment of painful diabetic peripheral neuropathy[J].J Diabetes Sci Technol,2022,16(2):282-288.DOI: 10.1177/19322968211060316.
    [124]
    WendlandDM,KlinePW,BohnertKL,et al.Offloading of diabetic neuropathic plantar ulcers: secondary analysis of step activity and ulcer healing[J].Adv Skin Wound Care,2023,36(4):194-200.DOI: 10.1097/01.ASW.0000919476.24220.cc.
    [125]
    VierhoutBP,VisserR,HuttingKH,et al.Comparing a non-removable total contact cast with a non-removable softcast in diabetic foot ulcers: a retrospective study of a prospective database[J].Diabetes Res Clin Pract,2022,191:110036.DOI: 10.1016/j.diabres.2022.110036.
    [126]
    WithersRV,PerrinBM,LandorfKB,et al.Offloading effects of a removable cast walker with and without modification for diabetes-related foot ulceration: a plantar pressure study[J].J Foot Ankle Res,2023,16(1):27.DOI: 10.1186/s13047-023-00625-z.
    [127]
    BerhaneT,JeyaramanK,HamiltonM,et al.Offloading interventions for the management of Charcot neuroarthropathy in diabetes[J].Foot Ankle Orthop,2025,10(1):24730114251315670.DOI: 10.1177/24730114251315670.
    [128]
    GratwohlV,JentzschT,SchöniM,et al.Long-term follow-up of conservative treatment of Charcot feet[J].Arch Orthop Trauma Surg,2022,142(10):2553-2566.DOI: 10.1007/s00402-021-03881-5.
    [129]
    PremR,VignarajaV,LewisT,et al.Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: a systematic review[J].SAGE Open Med,2024,12:20503121241306957.DOI: 10.1177/20503121241306957.
    [130]
    MacdonaldKE,BoeckhS,StaceyHJ,et al.The microbiology of diabetic foot infections: a meta-analysis[J].BMC Infect Dis,2021,21(1):770.DOI: 10.1186/s12879-021-06516-7.
    [131]
    DuF,MaJ,GongH,et al.Microbial infection and antibiotic susceptibility of diabetic foot ulcer in china: literature review[J].Front Endocrinol (Lausanne),2022,13:881659.DOI: 10.3389/fendo.2022.881659.
    [132]
    NieuwlandAJ,WaibelFWA,FluryA,et al.Initial antibiotic therapy for postoperative moderate or severe diabetic foot infections: broad versus narrow spectrum, empirical versus targeted[J].Diabetes Obes Metab,2023,25(11):3290-3297.DOI: 10.1111/dom.15228.
    [133]
    RosselA,LebowitzD,GarianiK,et al.Stopping antibiotics after surgical amputation in diabetic foot and ankle infections-a daily practice cohort[J].Endocrinol Diabetes Metab,2019,2(2):e00059.DOI: 10.1002/edm2.59.
    [134]
    PhamTT,GarianiK,RichardJC,et al.Moderate to severe soft tissue diabetic foot infections: a randomized, controlled, pilot trial of post-debridement antibiotic treatment for 10 versus 20 days[J].Ann Surg,2022,276(2):233-238.DOI: 10.1097/SLA.0000000000005205.
    [135]
    Cortes-PenfieldNW,ArmstrongDG,BrennanMB,et al.Evaluation and management of diabetes-related foot infections[J].Clin Infect Dis,2023,77(3):e1-e13.DOI: 10.1093/cid/ciad255.
    [136]
    BarwellND,DeversMC,KennonB,et al.Diabetic foot infection: antibiotic therapy and good practice recommendations[J].Int J Clin Pract,2017,71(10).DOI: 10.1111/ijcp.13006.
    [137]
    KwonKT,ArmstrongDG.Microbiology and antimicrobial therapy for diabetic foot infections[J].Infect Chemother,2018,50(1):11-20.DOI: 10.3947/ic.2018.50.1.11.
    [138]
    LiY,LiL,LinH,et al.Cold atmospheric plasma for promoting healing and anti-infection of chronic wounds: a meta-analysis[J].Clin Lab,2025,71(3).DOI: 10.7754/Clin.Lab.2024.241028.
    [139]
    PastoriD,CormaciVM,MarucciS,et al.A comprehensive review of risk factors for venous thromboembolism: from epidemiology to pathophysiology[J].Int J Mol Sci,2023,24(4):3169.DOI: 10.3390/ijms24043169.
    [140]
    MangwaniJ,Houchen-WolloffL,MalhotraK,et al.UK foot and ankle thromboembolism (UK-FATE)[J].Bone Joint J,2024,106-B(11):1249-1256.DOI: 10.1302/0301-620X.106B11.BJJ-2024-0128.R1.
    [141]
    BartlettMA,MauckKF,StephensonCR,et al.Perioperative venous thromboembolism prophylaxis[J].Mayo Clin Proc,2020,95(12):2775-2798.DOI: 10.1016/j.mayocp.2020.06.015.
    [142]
    BonacaMP,BauersachsRM,AnandSS,et al.Rivaroxaban in peripheral artery disease after revascularization[J].N Engl J Med,2020,382(21):1994-2004.DOI: 10.1056/NEJMoa2000052.
    [143]
    BhardwajB,SpertusJA,KennedyKF,et al.Bleeding complications in lower-extremity peripheral vascular interventions: insights from the NCDR PVI registry[J].JACC Cardiovasc Interv,2019,12(12):1140-1149.DOI: 10.1016/j.jcin.2019.03.012.
    [144]
    HaisleyM,SørensenJA,SollieM.Postoperative pressure injuries in adults having surgery under general anaesthesia: systematic review of perioperative risk factors[J].Br J Surg,2020,107(4):338-347.DOI: 10.1002/bjs.11448.
    [145]
    WeiM,WuL,ChenY,et al.Predictive validity of the Braden Scale for pressure ulcer risk in critical care: a meta-analysis[J].Nurs Crit Care,2020,25(3):165-170.DOI: 10.1111/nicc.12500.
    [146]
    BensonB,BensonA.Preoperative anesthetic considerations in the podiatric surgical candidate[J].Clin Podiatr Med Surg,2019,36(1):1-19.DOI: 10.1016/j.cpm.2018.08.001.
    [147]
    ZouL,WeiQ,PanS,et al.Comparison of the effects of combined femoral and sciatic nerves block versus general anesthesia on hemodynamic stability and postoperative complication in patients with diabetic foot: a prospective, double-blind and randomized controlled trial[J].Diabetes Metab Syndr Obes,2024,17:2243-2257.DOI: 10.2147/DMSO.S465814.
    [148]
    KnufKM, MaaniCV, CummingsAK. Clinical agreement in the American Society of Anesthesiologists physical status classification[J]. Perioper Med (Lond), 2018, 7: 14.DOI: 10.1186/s13741-018-0094-7.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(6)

    Article Metrics

    Article views (317) PDF downloads(176) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return