New Insights into Diabetic Foot

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 853

Special Issue Editors


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Guest Editor
1. King's College Hospital, London, UK
2. Guy’s and St Thomas’ Hospitals, London, UK
Interests: diabetic foot syndrome; diabetic foot infection; diabetic foot osteomyelitis; peripheral arterial disease; ischaemic ulcer; diabetic neuropathy

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Guest Editor
Department of Systems Medicine, Universita degli Studi di Roma Tor Vergata, Roma, Italy
Interests: diabetes; diabetes complications; diabetic foot; wound care; cardiovascular disease; peripheral arterial disease
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Special Issue Information

Dear Colleagues,

Diabetic foot disease (DFD) is a clinical, social, and economic burden. It has been documented that 19–34% of persons with diabetes can develop a foot ulcer during their lifetime. In 2017, the global burden of disease study estimated that DFD incidence increased to 199 million people, involving around 2.6% of the global population. DFD also represents a significant cause of death (with an estimated mortality rate of 33–60% at 5 years), global disability (being the 13th most significant condition for the total disease burden), and hospitalization and readmission (22% of patients with diabetic foot ulcer require hospitalization within 6 months).

Despite significant reductions in major amputations over the past two decades, diabetic foot disease (DFD) continues to pose a substantial challenge for clinicians. Key areas of concern include neuropathy-induced disability, untreatable lower limb ischemia, the management of diabetic foot osteomyelitis, Charcot foot, advanced wound care, regenerative therapy, ulcer recurrence, and patient frailty. These issues represent crucial areas to improve our understanding, with the ultimate aim to minimize avoidable amputations and enhance patients' quality of life.

This Special Issue is dedicated to all clinicians and researchers involved in diabetes and diabetic foot care. It aims to present the current state of the art in DFD management and to explore potential future therapeutic and research avenues that could aid healthcare professionals. Its focus spans various disciplines, including endocrinology, neurology, and vascular and orthopedic surgery, as well as those in general medicine.

Dr. Prashanth Vas
Dr. Marco Meloni
Guest Editors

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Keywords

  • diabetic foot syndrome
  • diabetic foot infection
  • diabetic foot osteomyelitis
  • peripheral arterial disease
  • ischaemic ulcer
  • diabetic neuropathy

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Published Papers (1 paper)

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Review

19 pages, 3227 KiB  
Review
Peripheral Arterial Disease in Diabetic Foot: One Disease with Multiple Patterns
by Marco Meloni and Prashanth R. J. Vas
J. Clin. Med. 2025, 14(6), 1987; https://doi.org/10.3390/jcm14061987 - 14 Mar 2025
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Abstract
Peripheral arterial disease (PAD) is a major complication in individuals with diabetes and is increasingly prevalent in those with diabetic foot ulcers (DFUs). Despite this, the characterisation of PAD in diabetic patients remains insufficiently refined, leading to suboptimal management and outcomes. This review [...] Read more.
Peripheral arterial disease (PAD) is a major complication in individuals with diabetes and is increasingly prevalent in those with diabetic foot ulcers (DFUs). Despite this, the characterisation of PAD in diabetic patients remains insufficiently refined, leading to suboptimal management and outcomes. This review underscores the necessity for a more nuanced understanding of PAD’s anatomical and biological aspects in diabetic patients. The distribution of atherosclerotic plaques varies significantly among individuals, influencing prognosis and treatment efficacy. We describe three key patterns of PAD in diabetes: pattern 1 PAD—below-the-knee (BTK) disease (with infrageniculate disease where present); pattern 2—below-the-ankle (BTA) disease; and pattern 3—small artery disease (SAD), each presenting unique challenges and require tailored therapeutic approaches. BTK PAD, characterised by occlusions in the anterior tibial, posterior tibial, and peroneal arteries, necessitates targeted revascularisation to improve foot perfusion. BTA PAD, involving the pedal and plantar arteries, is associated with higher risks of amputation and requires advanced revascularisation techniques. SAD, affecting the small arteries of the foot, remains an enigma and is challenging to treat with the current mechanical methods, highlighting the potential of autologous cell therapy as a promising alternative. A refined characterisation of PAD in diabetes is crucial for developing effective, individualised treatment strategies, ultimately improving patient outcomes, and reducing the burden of diabetic foot complications. In light of these complexities, it is incredulous that we often use a single term, “peripheral arterial disease”, to describe such a diverse array of disease patterns. This oversimplification can be perilous, as it may lead to inadequate therapeutic approaches and suboptimal patient care. Full article
(This article belongs to the Special Issue New Insights into Diabetic Foot)
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