DIABETES MELLITUS

Biotechnological and local application of cultured fibroblasts and keratinocytes are reviewed in this section. And more specifically for diabetics suffering with neuropathic foot ulceration. About 10% of diabetics develop neuropathic foot sole ulceration. Most are recalcitrant in healing. Danger is spreading gangrene and septicaemia. Conventional treatment of diabetic foot ulcers consist of infection control, off-loading, special footwear. In some persons, excision of a metatarsal head may facilitate healing by removing a pressure point. Diabetics with non-ischaemic diabetic ulcers may benefit from cell therapy and transfer of cultured fibroblasts and keratinocytes to the ulcer bed. Topical basic fibroblast growth factor has almost no effect on the healing of neuropathic foot ulcers. Currently, Apligraft® and Dermagraft® can be considered for the biological healing of ulcers with cells. See Diabetes Care 2001; 24: 290-295.