New Diagnostic Tool May Predict Diabetic Foot Ulcer Recurrence

Diabetic foot ulcers are a major complication for people living with diabetes—and a leading cause of non-traumatic lower-limb amputations. Now, NIH-supported researchers say they have identified a promising diagnostic aid to help determine which patients are at greater risk of recurrence after an ulcer has healed.

The study, which was funded by the National Institutes of Health and which will be published in Diabetes Care, highlights a new approach that assesses how well the skin has truly healed by measuring trans-epidermal water loss (TEWL)—a marker of skin barrier function. The researchers found that even when a diabetic foot ulcer looks healed on the surface, the skin may still be compromised, increasing the chance of re-injury.

“This study is an important initial step to give clinicians treating diabetic foot ulcers a reliable diagnostic aid for the first time to assess an individual’s risk of ulcer recurrence,” said Teresa Jones, M.D. program director for the Division of Diabetes, Endocrinology, & Metabolic Diseases at NIH’s National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK). “Foot ulcers are such a confounding issue with diabetes and being able to determine which wounds are at highest risk for recurrence could save many lives and limbs.”

In the study, researchers followed more than 400 participants who had a diabetic foot ulcer that appeared to be closed or healed. They measured TEWL at the site of the foot ulcer and found that 35% of participants with high TEWL (more water loss) reported a wound recurrence by 16 weeks, compared to just 17% for those with low TEWL (less water loss). Participants with higher TEWL were 2.7 times more likely to experience a wound recurrence than participants with low TEWL.

The researchers believe TEWL measurement could become a useful tool in the clinical setting, helping providers determine when it’s safe to resume normal pressure on the foot or discharge a patient from care.

Supported by the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), this study underscores the value of new diagnostics in reducing long-term complications of diabetes.

You can read the full study HERE.