Sicco A. Bus

Assessment of foot disease in the home environment of diabetic patients using a new photographic foot imaging device.

The objective of this study was to compare live and photographic assessments of clinical signs of diabetic foot disease using a new photographic foot imaging device. High quality colour photographs of the plantar foot surface were collected in 20 diabetic feet using a prototype device and in 19 diabetic feet using a definitive version of the device with optimized illumination settings. All photographs were assessed independently by four observers for presence of ulceration, abundant callus, or absence of signs and compared with live and repeated photographic assessments of the feet by the same observers. Agreement between assessments was moderate to good for all outcomes using the prototype device (56–92%) and improved using the definitive version of the device (74–100%). The data seem to suggest that important signs of diabetic foot disease can be diagnosed from high quality photographs using the photographic foot imaging device. Intended for use as telemedical monitoring device in the patients home, frequent remote assessments may potentially contribute to the early recognition and treatment of foot disease, which may prevent further complications.

Effect of Single Dose of RANKL Antibody Treatment on Acute Charcot Neuro-osteoarthropathy of the Foot

Charcot neuro-osteoarthropathy is a rare condition that affects subjects with diabetes with neuropathy (1). Although the underlying pathophysiology is largely unknown, increased receptor activator of nuclear factor κ-B ligand (RANKL) activation in Charcot neuro-osteoarthropathy has been observed (2). As monoclonal RANKL antibody treatment (denosumab, Prolia) reduces osteoporosis-related fractures (3), we studied its effect on fracture resolution time and clinical outcomes in acute Charcot neuro-osteoarthropathy. All patients with diabetes seen at our foot clinic between 2012 and 2016 were categorized by modified Brodsky classification (4) and treated according to a standardized total contact cast (TCC) protocol. This comprises weekly TCC changes and subsequent conventional X-ray imaging every 4 weeks, as well as supplementation daily with calcium 500 mg/cholecalciferol 800 IE to achieve adequate plasma calcium (between 2.2 and 2.5 mmol/L) and vitamin D levels …

PS6 - 34. The effectiveness of offloading-improved custom-made footwear on plantar foot ulcer recurrence rate in diabetic patients: a multicenter randomized controlled trial

The aim of this study was to assess the effectiveness of custom-made footwear, of which offloading is improved based on in-shoe plantar pressure analysis, in preventing plantar foot ulcer recurrence in high-risk diabetic patients.