Factors ID'd in healing failure of diabetic foot ulcers

(HealthDay) -- Patients with diabetes whose foot ulcers fail to heal have increased inflammation and aberrant growth factor levels, according to a study published online June 11 in Diabetes.

Thanh Dinh, D.P.M., from the Beth Israel Deaconess Medical Center in Boston, and colleagues followed 104 patients with type 1 or 2 diabetes and 36 healthy controls to investigate whether vascular function and inflammation play a role in the development and healing of diabetic foot ulcers.

The researchers found that, after a mean of 18.4 months, 30 patients with diabetes (29 percent) developed foot ulcers. These patients had more severe neuropathy, a higher white blood cell count, and reduced vasodilation. Ulcers failed to heal in 47 percent of these patients. Compared with those who healed, these patients had higher serum levels of tumor necrosis factor-alpha, monocyte chemoattractant protein-1, matrix metallopeptidase 9 (MMP-9), and fibroblast growth factor 2. Compared with skin samples from control patients, patients with diabetes had greater immune cell infiltration, MMP-9 expression, and protein tyrosine phosphatase-1B (PTP1B).

"We conclude that increased inflammation, expression of MMP-9, PTP1B, and aberrant growth factor levels are the main factors associated with failure to heal diabetic foot ulcers," Dinh and colleagues write.

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