exenatide and Diabetic-Foot

A review of Type 2 diabetes mellitus is presented. Lifestyle recommendations with a focus on currently available medications are discussed. A case study involving a patient with diabetes mellitus and a foot ulcer is discussed in relation to current treatment recommendations.

Topics: Adult; Amyloid; Biguanides; Community Health Nursing; Diabetes Mellitus, Type 2; Diabetic Foot; Dipeptidyl-Peptidase IV Inhibitors; Exenatide; Glycated Hemoglobin; Glycoside Hydrolase Inhibitors; Home Care Services; Humans; Hypoglycemic Agents; Insulin; Islet Amyloid Polypeptide; Life Style; Male; Patient Education as Topic; Peptides; Sulfonylurea Compounds; Thiazolidinediones; Venoms; Wound Healing

Although models exist to predict amputation among people with type 2 diabetes with foot ulceration or infection, we aimed to develop a prediction model for a broader range of major adverse limb events (MALE)-including gangrene, revascularization and amputation-among individuals with type 2 diabetes.. In a post-hoc analysis of data from the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial, we compared participants who experienced MALE with those who did not. A multivariable model was constructed and translated into a risk score.. Among the 14,752 participants with type 2 diabetes in EXSCEL, 3.6% experienced MALE. Characteristics associated with increased risk of MALE were peripheral artery disease (PAD) (HR. The majority of MALE occurred among participants with PAD, but participants without a history of PAD also experienced MALE. A risk score with good performance was generated. Although it requires validation in an external dataset, this risk score may be valuable in identifying patients requiring more intensive care and closer follow-up.

Topics: Aged; Amputation, Surgical; Cardiovascular Diseases; Cohort Studies; Diabetes Mellitus, Type 2; Diabetic Foot; Exenatide; Female; Gangrene; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Male; Middle Aged; Peripheral Arterial Disease; Randomized Controlled Trials as Topic; Risk Factors; Sex Factors; Vascular Surgical Procedures