糖尿病足的诊断（接上篇）

首页
病情图文
- 糖尿病足
- 压疮
- 感染伤口
- 造口
- 溃疡
  
  动脉性溃疡
  
  静脉性溃疡
  
  放射性溃疡
- 烧伤
- 创伤
- 少见伤口
- 祛疤止痒
- 皮肤病
医师讲座
名医介绍
专业服务

糖尿病足

压疮

造口

溃疡

烧伤
蔡道章院长

Custom Mod Mega1

主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

中德骨科伤口管理学校校长

广东省骨科研究院运动医学研究所所长

广东省内运动医学专业唯一的博士研究生导师

美国哈弗大学医学院骨科访问学者

专业特长处于省内领先、国内或国际先进水平以上

2018年获得“国之名医卓越建树”荣誉称号

2017年被评为全国卫生计生系统先进工作者、广东省医学领军人才

中国医师协会运动医师分会副会长

STCOT中国部运动医学分会副主任委员

广东省医学会关节外科分会主任委员

广东省医学会运动医学会分会名誉主任委员

独立承担过国家“863”课题，主持过10余项省、部级科研项目

多份专业杂志编委
文献精选
伤口分类

糖尿病足

压疮

感染伤口

造口

溃疡

烧伤

更多关于伤口信息
最新文献

Metabolic challenges in rheumatoid arthritis: a translational overview from pathogenesis to patient care 2026-04-30 00:00

Sara Ferrigno1 · Eneida Çela1 · Mauro Fatica1,2 · Benedetta Monosi1 · Arianna D’Antonio1 · Paola Conigliaro1 · Marina Cardellini3,4 · Susanna Longo3,4 · Massimo Federici3,4 · Maria Sole Chimenti1

Received: 20 February 2026 / Accepted: 26 March 2026 © The Author(s) 2026

Abstract

Rheumatoid arthritis (RA) is an inflammatory disease characterized by a higher burden of cardiovascular and metabolic diseases than in the general population. Altered lipid and glucose metabolic pathways are widely observed, primarily due to chronic inflammation. However, metabolic dysfunction may also affect RA pathogenesis, further enhancing immune cell activation and joint damage. Glucose and lipid alterations observed in RA help define the comorbidity burden of this disease, significantly affecting disease activity and prognosis. The aim of the present review is to describe the role of metabolic dysfunctions in RA and to examine how disease activity and treatments can influence these conditions. We also summarized the main management strategies based on current literature and developed a cardiometabolic monitoring algorithm across different clinical settings to support daily patient care of these patients.

Keywords Rheumatoid arthritis · Glucose metabolism · Lipid metabolism · Atherogenesis · Inflammation · Immune-metabolism · Cardiovascular risk

Sara Ferrigno and Eneida Çela contributed equally to this manuscript

Communicated by Salvatore Corrao, M.D

Sara Ferrigno

该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy

2 Academic Rheumatology Unit, Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Giovanni Paolo II, C/da Tappino, Campobasso 86100, Italy

3 Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy

4 Center for Atherosclerosis, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy

Associations between cardiometabolic traits and diabetic cardiomyopathy: an imaging-based analysis 2026-04-29 00:00

Georgios Mavraganis1 · Dimitrios Bampatsias1,2 · Christina Konstantaki1 · Kamil Stankowski3,4 ·Stavros Athanasopoulos1 · Chrysoula Moustou1 · Alexandros Alexandropoulos1 · Stefano Figliozzi3,4 ·Angelos Soranides1 · Ioannis Petropoulos1 · Dimitrios Klettas5 · Kimon Stamatelopoulos1,6 ·Georgios Georgiopoulos1,7

Received: 12 December 2025 / Accepted: 15 March 2026 © The Author(s) 2026

Abstract

Introduction Diabetic cardiomyopathy (DCM) often evades diagnosis before manifestation of clinical symptoms. In this study we explored how cardiometabolic traits influence early cardiac structure and function in asymptomatic people living with diabetes (PwD), using advanced imaging.

Methods We conducted a cross-sectional study of 88 participants: 57 people living with type 2 diabetes (PwT2D), 16 people living with type 1 diabetes (PwT1D) and 15 controls. All subjects underwent transthoracic echocardiography and/or cardiac magnetic resonance (CMR) imaging. Strain analysis, perfusion indices, and tissue characterization (T1, T2, and extracellular volume) were assessed. Arterial stiffness via pulse wave velocity (PWV), ventricular-arterial coupling (VAC), circulating biomarkers and liver fibrosis indices were evaluated.

Results PwD had lower cardiac index than controls. Global longitudinal strain (GLS) and global radial strain were lower in both diabetes mellitus (DM) groups, while left atrial strain was most impaired in PwT2D (β-coefficient= − 11.77, P=0.003). DM duration≥10 years was associated with worse GLS (β-coefficient= − 2.18, P=0.033) and right VAC (β-coefficient= − 0.27, P=0.027) after multivariable analysis. While tissue characterization and perfusion indices showed no significant group differences, tight glycemic control in PwD correlated with improved myocardial strain parameters. PwT2D exhib-ited greater arterial stiffness (β-coefficient=1.52, P=0.003). In PwD, elevated non-alcoholic fatty liver disease score cor-related with increased left ventricular mass (β-coefficient=6,195, P=0.022) and decreased left ventricular ejection fraction (LVEF) (β-coefficient= − 3.12, P=0.017). Higher growth differentiation factor levels were associated with reduced LVEF (β-coefficient= − 0.005, P=0.029).

Conclusion This multimodal imaging study highlights myocardial and vascular changes in asymptomatic PwD. Early com-prehensive cardiovascular assessment may help identify dysfunction before overt heart failure develops.

Keywords Diabetic cardiomyopathy · Cardiac magnetic resonance · Echocardiography · Arterial stiffness · Ventricular-arterial coupling · Liver fibrosis
互动快递

糖尿病足的诊断（接上篇）

字号 + –

18 10月 2019

Author : 伤口世界

原创：胡海涛负压引流与创面修复

世界卫生组织(WHO)定义:糖尿病足是指糖尿病患者由于合并神经病变及各种不同程度末梢血管病变而导致下肢感染、溃疡形成和(或)深部组织的破坏。

三个必须条件，缺一不可：

糖尿病患者；
合并神经病变及不同程度末梢血管病变；
下肢感染、溃疡形成或深部组织坏死；

该患者疼痛明显、足背动脉博动好，不符合糖尿病足诊断标准2、3，所以排除糖尿病足诊断。伤口内见到痛风石、CT看到切口区域关节周围痛风结节较多，按痛风结节诊治方案处理，伤口愈合。

糖尿病足鉴别诊断：糖尿病患者合并痛风结节破溃、下肢动脉硬化闭塞、血栓闭塞性脉管炎等。

最后提醒：遇到糖尿病患者足溃疡时，第一步是诊断，第二步是鉴别诊断，尤其当治疗效果不好时，得再次思考这两个问题。

1492 Views

伤口世界

电子邮件地址该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Latest from 伤口世界

K2 Content

Metabolic challenges in rheumatoid arthritis: a translational overview from pathogenesis to patient care 2026-04-30 00:00

Sara Ferrigno1 · Eneida Çela1 · Mauro Fatica1,2 · Benedetta Monosi1 · Arianna D’Antonio1 · Paola Conigliaro1 · Marina Cardellini3,4 · Susanna Longo3,4 · Massimo Federici3,4 · Maria Sole Chimenti1

Received: 20 February 2026 / Accepted: 26 March 2026 © The Author(s) 2026

Abstract

Rheumatoid arthritis (RA) is an inflammatory disease characterized by a higher burden of cardiovascular and metabolic diseases than in the general population. Altered lipid and glucose metabolic pathways are widely observed, primarily due to chronic inflammation. However, metabolic dysfunction may also affect RA pathogenesis, further enhancing immune cell activation and joint damage. Glucose and lipid alterations observed in RA help define the comorbidity burden of this disease, significantly affecting disease activity and prognosis. The aim of the present review is to describe the role of metabolic dysfunctions in RA and to examine how disease activity and treatments can influence these conditions. We also summarized the main management strategies based on current literature and developed a cardiometabolic monitoring algorithm across different clinical settings to support daily patient care of these patients.

Keywords Rheumatoid arthritis · Glucose metabolism · Lipid metabolism · Atherogenesis · Inflammation · Immune-metabolism · Cardiovascular risk

Sara Ferrigno and Eneida Çela contributed equally to this manuscript

Communicated by Salvatore Corrao, M.D

Sara Ferrigno

该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Department of “Medicina dei Sistemi”, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy

2 Academic Rheumatology Unit, Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Via Giovanni Paolo II, C/da Tappino, Campobasso 86100, Italy

3 Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy

4 Center for Atherosclerosis, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy
Associations between cardiometabolic traits and diabetic cardiomyopathy: an imaging-based analysis 2026-04-29 00:00

Georgios Mavraganis1 · Dimitrios Bampatsias1,2 · Christina Konstantaki1 · Kamil Stankowski3,4 ·Stavros Athanasopoulos1 · Chrysoula Moustou1 · Alexandros Alexandropoulos1 · Stefano Figliozzi3,4 ·Angelos Soranides1 · Ioannis Petropoulos1 · Dimitrios Klettas5 · Kimon Stamatelopoulos1,6 ·Georgios Georgiopoulos1,7

Received: 12 December 2025 / Accepted: 15 March 2026 © The Author(s) 2026

Abstract

Introduction Diabetic cardiomyopathy (DCM) often evades diagnosis before manifestation of clinical symptoms. In this study we explored how cardiometabolic traits influence early cardiac structure and function in asymptomatic people living with diabetes (PwD), using advanced imaging.

Methods We conducted a cross-sectional study of 88 participants: 57 people living with type 2 diabetes (PwT2D), 16 people living with type 1 diabetes (PwT1D) and 15 controls. All subjects underwent transthoracic echocardiography and/or cardiac magnetic resonance (CMR) imaging. Strain analysis, perfusion indices, and tissue characterization (T1, T2, and extracellular volume) were assessed. Arterial stiffness via pulse wave velocity (PWV), ventricular-arterial coupling (VAC), circulating biomarkers and liver fibrosis indices were evaluated.

Results PwD had lower cardiac index than controls. Global longitudinal strain (GLS) and global radial strain were lower in both diabetes mellitus (DM) groups, while left atrial strain was most impaired in PwT2D (β-coefficient= − 11.77, P=0.003). DM duration≥10 years was associated with worse GLS (β-coefficient= − 2.18, P=0.033) and right VAC (β-coefficient= − 0.27, P=0.027) after multivariable analysis. While tissue characterization and perfusion indices showed no significant group differences, tight glycemic control in PwD correlated with improved myocardial strain parameters. PwT2D exhib-ited greater arterial stiffness (β-coefficient=1.52, P=0.003). In PwD, elevated non-alcoholic fatty liver disease score cor-related with increased left ventricular mass (β-coefficient=6,195, P=0.022) and decreased left ventricular ejection fraction (LVEF) (β-coefficient= − 3.12, P=0.017). Higher growth differentiation factor levels were associated with reduced LVEF (β-coefficient= − 0.005, P=0.029).

Conclusion This multimodal imaging study highlights myocardial and vascular changes in asymptomatic PwD. Early com-prehensive cardiovascular assessment may help identify dysfunction before overt heart failure develops.

Keywords Diabetic cardiomyopathy · Cardiac magnetic resonance · Echocardiography · Arterial stiffness · Ventricular-arterial coupling · Liver fibrosis
Role of automated insulin delivery (AID) systems in glucose control in patients with diabetes mellitus undergoing dialysis in Calabria: AID-DIAL-CAL 2026-04-28 00:00

Elena Succurro1,2 · Giuseppe Cersosimo3 · Paola Sarnelli4 · Francesco Brisinda1 · Ilaria Gattuso1 · Valeria Mazza1 ·Giuseppe Fabiano1 · Fiorella Iorio3 · Roberta Arena3 · Giovanni Mazzitello5 · Ramona Nicotera5 · Maria Capria1 ·Gianluigi Zaza6 · Michele Andreucci1 · Raffaele Mancini5 · Francesco Andreozzi1,2

Received: 22 December 2025 / Accepted: 16 March 2026© The Author(s) 2026

Abstract

Aims To describe the main glycemic outcomes and the Quality of Life (QOL) observed in a cohort of people with type 1(T1D) or type 2 (T2D) insulin-treated diabetes under dialysis who started an Automated Insulin Delivery (AID) system.

Methods This is a longitudinal retrospective pilot real-world analysis of 14 individuals with T1D and T2D undergoingdialysis who began using an AID system to optimize glycemic control. All subjects used the MiniMed™ 780G system. Glu-cose metrics were collected at baseline, 3, 6, and 12 months after initiating the SmartGuard™ feature. The WHOQoL-Bref questionnaire was administered at the last follow-up to evaluate the QOL.

Results Out of the 14 people, 8 reached 1-year follow-up. Time in Range (TIR) increased from 63% at baseline to 69% at 12 months, Time Below Range <70 mg/dL (TBR70) decreased from 0.3% to 0%, and Time Above Range >250 mg/dL (TAR250) decreased from 6.7% to 3.9%. Seven out of eight subjects who reached a 12-month follow-up achieved all three glycemic targets for this fragile population (TIR>50%, TBR70<1% and TAR250<10%). At the last follow-up, 58.3% of the users were satisfied or very satisfied with their health status, versus only 25% with the previous treatment, and 81.7% had a good or very good QOL, whereas only 8.3% had a good QOL, and no one had a very good QOL with the previous

Conclusion This pilot real-world study showed how the use of an AID system is safe and can help to improve the glycemic outcomes and the QOL of people with diabetes in dialysis.

Keywords Automated insulin delivery system · End-stage kidney disease · Dialysis · Time in range · Diabetes mellitus · Quality of Life

Communicated by Salvatore Corrao, M.D

Elena Succurro

该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro 88100, Italy

2 Research Center for the Prevention and Treatment of Metabolic Diseases (CR METDIS), University Magna Graecia of Catanzaro, Catanzaro, Italy

3 Azienda Ospedaliera Annunziata Cosenza, Cosenza, Italy

4 ASL Viterbo, Viterbo, Italy

5 ASP Catanzaro, Catanzaro, Italy

6 Department of Civil Engineering, University of Calabria, Rende, Italy

Popular Tags

学术会议

2019广东省医疗行业协会伤口管理分会年会

扫一扫了解详情:

2019年6月15日中国广州
主办单位：广东省医疗行业协会伤口管理分会

伤口世界提示

任何关于疾病的建议都不能替代执业医师的面对面诊断。所有门诊时间仅供参考，最终以医院当日公布为准。

网友、医生言论仅代表其个人观点，不代表本站同意其说法，请谨慎参阅，本站不承担由此引起的法律责任。

Custom Mod Mega1

主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长