Call for neater team healthcare for patients with diabetic foot

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Cheryl Wang and Shaoyun Wang

Shanghai Jiaotong University, China

: Endocrinol Diabetes Res

Abstract

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Regardless of enormous effort we put, diabetic foot remains challenging for physicians, surgeons, scientists, patients, and the society. Diabetic foot is a complicated pathogenesis progress, with nerve, vessels, local pressure, inflammation and infections involved. Better blood sugar control, local debridement, wound care, and tissue regenerative are quite essential for better outcome. Neater team healthcare is essential to prevent leg amputation. Regular checkup shall be performed by patients themselves on daily basis, by podiatrists on routine visits. Better diabetes control effort shall be carried by diabetologists, patients, nutrition, diabetic educators and family and social support. Agents softening arteries, blood thinner, anti-platelets, and lipid-lowering may be used on regular basis. Positive attitude and stress management can be practiced by patients, family, psychiatrists, psychologists, activists, social workers. The local necrotic tissues, infections, inflammation and other insults block the oxygenation and nutrition of the vessels and tissues, and as such prevent the wound from healing. Thorough debridement carried by wound care nurses, surgeons, and practitioners shall lay a whole picture of the patient’s situation, as well as the local blood supply and infections, cautions shall be paid for the direction of tunnels and oozing to make sure excessive discharge drained well, to offer a fresh, better oxygenated, and relatively healthier setting that promotes the growth of new tissues and vessels. Tips like avoiding pressure/weight on the foot, elevation of the lower limbs, comfort and fit footwear and shoes, regular self-checking of the feet with/without mirror shall reminded and urged by patients themselves, the family, nurses and physicians.

Vascular surgeons may do their best to reconstruct the blood supply. Orthopedic surgeons may take effort to salvage as neat as possible. Stem cell bioengineering can be applied for tissue and vessel regeneration after the debridement, with a nice scientific team work consist of bioengineers, cell scientists, immunologists, bioconduct companies, pharmacists, physical therapists, experts for regenerative medicine etc. Mesenchymal derived stem cells (MDSC) and adipocytes derived stem cells (ADMS) can be autologous or endogenous. Endogenous stem cells and tissueengineered implant can be applied with immunopression with scalable tech using biconstruct transplantation. Exosome from stem cells culture media is found rich in MALAT1 that is essential for wound healing. Local injection of neural growth factor (NGF), TPO, soluble stem cell recruitment factors (SDF-1), inflammation-modulators, progenitors, nitrate oxide (NO), hypoxia indicible factor (HIF-1a) can promote the growth of vessels, angiogenesis, and the regeneration of the tissues. Local light energy can also be used for better outcome. No man can move the mountain along. With neater team healthcare, not only it will benefit diabetic foot, but wound care and regenerative medicine of any kind.

Recent Publications

1. Cheryl Wang, MD, PhD. Happy booster, How positive attitude promotes health, reduces stress, enhances performance, accelerates performance, and boosts happiness. IJDMD 2018, 3(4): 1-4.

2. Cheryl Wang, MD, PhD. Happy booster. Outskirtspress.com. 2018. ISBN 9781478794790.

3. Cheryl Wang, MD, PhD, Tongying Zhang, Jiali Wang, Shaoqing Wang, Xiaoyue Xu, Yiheng Wang. Our family chicken soup to all the beautiful you: my gratitude journal to you all. Outskirts press, 2017. ISBN 9781478791089.

4. Wang C. The effect of dietary protein on weight loss, satiety and appetite hormone. ASNH, 2019, 3(2): 96-102.

5. Wang C. Chorea associated with nonketotic hyperglycemia: a case report. International Journal of diabetes and metabolic disorder, 2019, 4(1): 1-2

Biography

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Cheryl Wang, MD, PhD, earned her MD at Binzhou Medical College, MSc., Endocrinology and metabolism, internal medicine in Shanghai Second Medical University (now Shanghai Jiaotong University), PhD in Science, Endocrinology and metabolism, internal medicine at PLA medical college. She did internal medicine residency and trained as an Endocrinologist in Donying People’s Hospital, China, did surgery residency at Mount Sinai and Rutgers in the United States. She was a fellow of obesity at Pennington, of Diabetes at UTHSCSA, of endocrinology at Mayo clinic, of Anesthesia at UB and Columbia Uni, of immunology, surgery, and ob & gyn at Pitts, of hematology and oncology at UM, a CRC at Cetero, a tech at RIKEN, a translator, medical writer, and editor of Medimedia and many companies, an assistant professor at UB and Pennington, a professor and endocrinologist at Affiliated Hospital of Taishan Medical College. She also had short training at Harvard medical centers, Cleveland Clinic, Cornell, Banner health, SUNY, UB, etc. She is currently a distinguished professor and endocrinologist at Shengli Oilfield Central Hospital. She had accomplished her masterpiece, her hard-won wisdom, “happy booster-how positive attitude promotes health, reduces stress, enhances performance, accelerates success and boosts happiness”, the best of America and Chinese best, the most positive energy ever, and a Nobel Prize “Winner-to-be”.

E-mail: dr.doc.cheryl.wanq@outlook.com