Diabetic foot is a condition exhibiting any pathology that results directly from diabetes mellitus or chronic complication of diabetes mellitus.
1. Neurology Disorders: pathological changes of sensory nerve, motor nerve and autonomic nerve.
2. Vascular pathological changes.
3. Circulation problem.
4. Immune disorder.
5. Reduction of insulin-like growth factor 1 (IGF-1) in skin.
The symptoms and physical signs differ from the disease course and degree. For mild patient, only mild pain and ulcer in the skin surface will be noted. For moderate case, relatively deep penetrated ulcer complicated with inflammation of soft tissue may occur. For severe case, ulcer complicated with abscess of soft tissue, pathological change of bone tissue, gangrene in toes, heel, front or back side of foot will occur, even gangrene in the whole foot may happen.
Wagner Classification of Diabetic Foot
Grade 0: No ulcer in a high risk foot, including ①pathological changes of peripheral nerve and autonomic nerve②pathological changes of peripheral vessels③with a medical history of ulcers in foot 4.deformity of foot⑤complicated with callosity or corn⑥lose sight or suffer from severe decreased vision⑦complicated with renal disorders, especially chronic renal function failure⑧senile patients or the ones who cannot observe their feet by themselves, especially for who lives lonely⑨loss of sensation⑩lack of diabetes knowledge.
• Grade 1: Superficial ulcer in foot skin without infection.
• Grade 2: Deep ulcer, penetrating down to ligaments and muscle, but no bone involvement or abscess formation.
• Grade 3: Deep ulcer with cellulitis or abscess formation, often with osteomyelitis.
• Grade 4: Ischemic ulcer and localized gangrene, usually complicated with neuropathy. No severe pain feeling. Infection may occur in the surface of necrosis tissue.
• Grade 5: Extensive gangrene involving the whole foot.
Treatment for Diabetic Foot in ReLife
Treatment options for diabetic foot available are medications, surgery treatment, and stem cell implantation. While controlling the blood glucose (insulin is mostly recommended), medications to improve micro-circulation, nerve function, anti-inflammation treatment are commonly applied. Stem cell therapy is a new treatment option for diabetic foot that develops in recent years.
Cell-based Gene Therapy for Diabetic Foot
Utilizing the molecular biology method, cell-based gene therapy is an innovative treatment method that implants the hepatocyte growth factor – HGF via autologous cells into the lesion area of the patient’s body. It can continuously and stably repair the lesion and improve the blood circulation, so as to improve islet function and accelerate the heal of wound in the foot, achieving the purpose of relieving patients’ symptoms.
Adipose tissue is full of adipose stem cells, which have the ability to be easily cultivated in vitro and multiple differentiation capacity. It can effectively participate in the regenerative and repair procedures of islet cells and the foot.
Adipose tissue is an active endocrine and paracrine organ, which secretes various cytokines and biological factors. The regular secretion of adipose tissue regulates and controls the balance of energy in body, and also plays a role in many procedures, such as anti-inflammation.
By taking advantage of adipose stem cell tropism, HGF will be carried into the illed ovarian region by adipose stem cells, enabling HGF continuously and stably effect and improve the blood circulation, as well as improve the survival rate and efficiency of adipose stem cells, which makes the treatment effect much better than single application of stem cell therapy. It plays a key role in overcoming the reproductive disorders, repairing the impaired ovarian function, and promoting the balance of endocrinology system.