伤口世界

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星期三, 11 9月 2019

糖尿病外周血管病变诊疗（上）：2019年版IWGDF有关糖尿病足指南的学习心得（四）

原创：十六点五中山二院糖尿病足中心

人们对于糖尿病外周血管病变越来越关注，一方面，它是糖尿病足形成的最重要的原因；另一方面，它也是糖尿病进展到一定程度的标志，严重的糖尿病外周血管病变，往往标志着糖尿病进展到晚期，心、肾、脑、眼底等重要脏器的血管也存在严重的问题，而糖尿病足长期的皮肤溃疡不愈合，其产生的大量炎症因子，也会加重这些血管病变，因此，如何评价（诊断）及治疗糖尿病外周血管病变，成为了糖尿病诊断和治疗的最重要的领域。

星期三, 11 9月 2019

糖尿病足的预防：2019年版IWGDF有关糖尿病足指南的学习心得（三）

原创：十六点五中山二院糖尿病足中心

糖尿病足的预防是各种指南中最重要的部分，无论是国内还是国外的，在各版的IWGDF指南都是重要内容，而且说明得特别详细及有比较多得循证医学的证据支持。但比较几个版本的IWGDF指南及国内外其他指南，这部分是肯定存在的，从中可以看出“糖尿病足的预防”已经深入人心。

星期三, 11 9月 2019

2019年版IWGDF有关糖尿病足指南的学习心得（二）

原创：十六点五中山二院糖尿病足中心

糖尿病足实质上就是一种糖尿病人足部出现难以愈合的皮肤慢性溃疡，如何使糖尿病人足部皮肤慢性溃疡愈合是糖尿病足治疗的中心，因此，围绕足部皮肤慢性溃疡愈合是糖尿病足治疗的中心环节。

星期三, 11 9月 2019

对2019年版IWGDF有关糖尿病足指南的学习心得（一）

原创：十六点五中山二院糖尿病足中心

IWGDF（The International Working Group on the Diabetic Foot）是一个以欧美从事糖尿病足工作的专家为主的，有其他大洲有关专家共同组成的，目前国际上有关糖尿病足的预防、诊断、治疗、研究、管理等方面最专业的国际组织之一（基本上没有之一）。

星期三, 11 9月 2019

糖尿病足局部创面的抗菌治疗（4）

原创：十六点五中山二院糖尿病足中心

脓腔切开，3型安尔碘纱布填塞一天之后，重新打开伤口，进行第二次清创，这次清创也是非常重要的。一般需要完成三个任务：探查创面、鉴别坏死及感染的组织、仔细清除各种需要清除的组织。

星期三, 11 9月 2019

糖尿病足局部创面的抗菌治疗（3）

原创：十六点五中山二院糖尿病足中心

（3）要把足部被细菌侵袭的各个空隙最好都能打开，尤其是足部比较重要的“空隙”，也是为了引流充分。

K2 Content

Diabetes remission in the real world 2024-09-20 00:00

Pam Brown

GP in Swansea

Citation: Brown P (2024) Diabetes Distilled: Diabetes remission in the real world. Diabetes & Primary Care 26: 145–7

Diabetes remission is achievable at scale in the real world, according to early results from the NHS Type 2 Diabetes Path to Remission programme published in Lancet Diabetes & Endocrinology. Of 7540 people referred to the programme between September 2020 and December 2022, a total of 1740 started the total diet replacement section of the programme before January 2022, and 960 (55%) completed the programme. Mean weight loss for the 1710 who started the programme and had follow-up data available was 9.4 kg (8.3%), with a mean weight loss of 10.3 kg (9.3%) among the 945 who completed the programme. Amongst the 945 who completed the programme and had two HbA1c measurements, 32% achieved remission, with mean weight loss of 15.9 kg (14.4%), while overall 27% of those who started the programme achieved remission regardless of whether they completed. Remission rates are lower than in trials such as DiRECT and DIADEM-I, despite similar levels of weight loss. The authors highlight that an additional 17% of participants met the HbA1c targets for remission but continued on metformin and may otherwise have achieved remission. These early results confirm that type 2 diabetes remission is indeed possible at scale in the real world, outside of clinical trials.
Impact of metformin timing on glucose and GLP-1 response 2024-09-19 00:00

Pam Brown GP in Swansea

Citation: Brown P (2024) Diabetes Distilled: Impact of metformin timing on glucose and GLP-1 response. Diabetes & Primary Care 26: 143–4

Glucose-lowering effects in response to normal-release metformin are greater when the drug is given 30 or 60 minutes before, rather than with, food, according to this small study in people with well-controlled type 2 diabetes published in Diabetologia. Endogenous GLP-1 secretion increased when metformin 1000 mg was given 30 or 60 minutes prior to a glucose infusion, whereas there was no increase when the metformin was administered at the same time as the glucose. The results suggest that, if tolerated, administering standard release metformin before meals may lead to improved postprandial glycaemic control.
The importance of getting the correct diabetes diagnosis 2024-09-18 00:00

Jane Diggle Specialist Diabetes Nurse Practitioner, West Yorkshire

Citation: Diggle J (2024) The importance of getting the correct diabetes diagnosis. Diabetes & Primary Care 26: 111–2

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

伤口世界