What is a Diabetic Foot Ulcer?
People who suffer from diabetes are at risk of developing ulcers on their feet. Diabetic foot ulcers affect up to 15 percent of diabetic patients, and over 80 percent of lower leg amputations are done in the treatment of this condition.
What causes a Diabetic Foot Ulcer?
Diabetic foot ulcer is a complication resulting from physiological changes due to the patient’s diabetes mellitus. Due to the vascular pathologies and neuropathy that results from diabetes, wound healing is compromised.
- Diabetes is thought to cause changes in the bony architecture of the foot, leading to predisposition to injury. The glycosylation from diabetes causes the ligaments to be stiffer, leading to loss of coordination and control of foot movements. The increased mechanical stresses on the foot from this condition can cause small, undetected wounds that can eventually lead to diabetic foot ulcer.
- There are changes in the vasculature, including atherosclerosis (stiffening of the blood vessels), calcification of arteries, and thickening of capillary basement membranes. The compromised blood flow leads to poor healing of injuries, such as wounds and breaks in the skin. Rather than being replaced by normal tissue, tissue degeneration and ulceration occur.
- Another complication of diabetes is peripheral neuropathy, leading to decreased sensation around the foot. Due to this loss of sensation, injuries to the foot are not noticed, often until too late.
What is the standard treatment for diabetic foot ulcers?
The treatment of diabetic foot ulcers is complicated and requires a multi-specialty team composed of orthopedic surgeons, internists, and rehabilitation specialists. The standard treatment of diabetic foot ulcer is the administration of antibiotics to prevent infection, debridement of damaged tissues, and proper wound dressing.
How are amniotic stem cells used in the treatment of diabetic foot ulcers?
Stem cell therapy for the treatment of diabetic foot ulcers is based on the goal of promoting better wound healing and cellular reconstruction with pluripotent cells. Among the many kinds of stem cells that are being explored for treatment are mesenchymal stem cells, which are derived from the amniotic membrane, as well as other tissue types, including bone marrow, umbilical cord blood, and fat tissue.
Mesenchymal stem cells are among the most commonly studied stem cells. They have been shown to differentiate into many different kinds of tissue. They are easy to collect and do not elicit a strong immune response. Studies have shown that the transplantation of mesenchymal stem cells has positive effects on diabetic foot ulcers, which include:
- Cell proliferation
- Collagen synthesis
- Release of growth and healing factors
- Growth of new blood vessels
- Wound contraction
Amniotic stem cells have been used clinically for diabetic foot ulcers extensively over the past decade. Whereas traditional treatments work slowly for healing diabetic ulcers, the amniotic therapy often heals them much quicker.
With the amniotic fluid being so readily available and having no rejection, it’s a great option as there is often a problem using a diabetic individual’s own bone marrow adipose tissue for stem cell therapy. For that reason, the “ready to go” amniotic therapy is excellent!
Blumberg SN, Berger A, Hwang L, Pastar I, Warren SM, Chen W. The role of stem cells in the treatment of diabetic foot ulcers. Diabetes Res Clin Pract. 2012 Apr;96(1):1-9. doi: 10.1016/j.diabres.2011.10.032.
Futrega K, King M, Lott WB, Doran MR. Treating the whole not the hole: necessary coupling of technologies fordiabetic foot ulcer treatment. Trends Mol Med. 2014 Mar;20(3):137-42. doi: 10.1016/j.molmed.2013.12.004.