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Researchers funded by the National Institutes of Health (NIH) have identified a promising diagnostic method to assess the risk of diabetic foot ulcer recurrence, potentially advancing clinical care for millions living with diabetes. The study highlights the use of trans-epidermal water loss (TEWL) measurements as an indicator of the skin’s barrier function, offering a new way to determine if seemingly healed wounds are fully restored beneath the surface.
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The research, conducted through the NIH’s National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) Diabetic Foot Consortium, evaluated over 400 individuals whose foot ulcers appeared to have healed. TEWL levels were measured at the site of the former ulcer, revealing that patients with higher water loss were 2.7 times more likely to experience wound recurrence within 16 weeks compared to those with lower TEWL. Specifically, 35% of participants with high TEWL experienced recurrence, versus 17% with low TEWL.
Diabetic foot ulcers are a significant complication of diabetes, often unnoticed due to neuropathy, and they remain the leading cause of non-traumatic lower-limb amputations. Although wounds may look healed externally, insufficient restoration of the skin’s barrier can leave patients vulnerable to infections and further injury. This study’s findings suggest that fully restoring barrier function should become a standard part of wound management to reduce the risks of recurrence and severe outcomes.
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The study is set to be published in Diabetes Care, the journal of the American Diabetes Association. Funding was provided through several NIH/NIDDK grants, and the work was conducted by members of the Diabetic Foot Consortium. By integrating TEWL measurements into clinical practice, healthcare providers could gain a more reliable tool to identify patients at highest risk and potentially prevent severe complications before they arise.
Article by multiple RFHC contributors, based upon information from the National Institutes of Health (NIH)
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