جستجوی مقالات مرتبط با کلیدواژه « زخم پای دیابتی » در نشریات گروه « پزشکی »

Emotional distress and sleep quality are effective in controlling the disease and its complications in patients with diabetic foot ulcers.(Emotional distress and poor sleep quality negatively affect the management of diabetes and it’s complications in patients with diabetic foot ulcers. Therefore, the present study was conducted to determine the predictors of emotional distress and sleep quality in patients with diabetic foot ulcers.

This  descriptive cross-sectional study was conducted in 2022. One hundred and nine patients with diabetes referred to Velayat Hospital in Qazvin City, Iran, were included in the study following convenience sampling. The study tools included a demographic checklist, the University of Texas Wound Classification System, the Petersburg Sleep Quality Index (PSQI), and the Emotional Distress Questionnaire (IR-PAID-20). The data was analyzed using SPSS-v25 software.

The majority of the patients had grade 3 (48.6%) and stage A (47.7%) wounds. The total scores of emotional distress and sleep quality were 49.81±19.94 and 10.21±4.02, respectively. Factors such as sleep quality, wound grade, wound stage, type of treatment, blood sugar level, and duration of diabetic foot ulcer were identified as predictors of emotional distress (p<0.05). Emotional distress, wound grade, wound stage, and amputation history were identified as factors predicting the sleep quality of patients (p<0.05).

Wound status was identified as a common predictor of emotional distress and sleep quality in diabetic foot ulcer patients. It is recommended to focus on the factors affecting emotional distress and sleep quality to make interventions to improve these components in patients with diabetic foot ulcers.

Foot ulcers in diabetic patients are one of the common complications of diabetes mellitus that can lead to death and amputation. Managing these ulcers is one of the significant challenges for patients and their families. In this case study, according to the patient's physical and financial condition, a resistant diabetic foot ulcer was treated using maggot therapy.

This report relates to a 72-year-old man with a 5-year history of uncontrolled type 2 diabetes. The patient had a 1 × 1 cm gangrenous diabetic foot ulcer on his left heel that was resistant to antibiotic treatment. Despite regular care, the diabetic foot ulcer did not heal. The patient was referred to our wound management team, and the diabetic foot ulcer was treated using surgical debridement and larval therapy. Ten sessions of maggot therapy were conducted (one therapeutic session every 48 hours). After three months, the patient's diabetic foot ulcer improved, and was discharged in a better condition.

Infectious diabetic foot ulcers cause activity impairment and decrease the quality of life of the patient due to resistance to treatment and poor healing. Therefore, effective treatment approaches are necessary for managing diabetic foot ulcers. This case report demonstrated that surgical debridement and maggot therapy are safe and effective approaches to healing diabetic foot ulcers.

 Diabetes is associated with dysfunction and damage in various organs due to abnormal pressure on ten plantar regions. This study aims to compare the effect of offloading plantar pressure on peak pressure of ten plantar regions and gait speed in men with diabetes and active diabetic foot ulcers, and healthy men.

Methods:

 This is a causal-comparative study. Participants were 30 healthy men, 30 diabetic men and 30 men with active diabetic foot ulcers who needed no leg amputation according to their physicians. Sampling was done using random and convenience methods. Diabetic foot ulcers were classified based on the Meggitt-Wagner classification criteria, according to which grade 1 indicates grade 1 indicates a superficial ulcer and was used as a criterion for selecting people with diabetic foot ulcers. Plantar pressure variables were recorded using RSscan software (RSscan International, Belgium; 0.5×0.5×0.02 m, 4363 sensors) at a sampling frequency of 300 Hz and the gait speed was measured using a digital stopwatch. Correct walking considered as the full impact of the foot on the middle of the foot scan machine. Data were analyzed using independent t-test in SPSS software, version 24.

Results:

 The peak pressure in the metatarsal 3 (P<0.001), metatarsal 4 (P= 0.020), medial heel (P= 0.004) and lateral heel (P= 0.007) in the diabetic foot ulcer group significantly increased compared to the diabetic group. In addition, the peak pressure in the medial heel (P= 0.013) and lateral heel (P= 0.019) in the diabetic group significantly decreased compared to the healthy group.

Conclusion:

 Men with diabetic foot ulcers are more exposed to abnormal peak pressures in different plantar regions, which can cause irreversible clinical injuries. Diabetic men have a lower gait speed than healthy men which can be important in their rehabilitation.

One of the most common complications of diabetes is diabetic foot ulcer, which exposes patients to wound infection, osteomyelitis, and lower-limb amputation if left untreated. Therefore, accurate and rapid diagnosis of wound and osteomyelitis infection is an important step in treating this debilitating complication. In this regard, the present study was aimed to determine the incidence of osteomyelitis and assess its risk factors in patients with diabetic foot ulcers during 2013 and 2016 in Birjand, Iran. This epidemiological analytical-retrospective study was conducted using numerical sampling. Demographic and clinical data were obtained by reviewing patients’ medical records and using a checklist developed by the project manager. Data analysis was performed using SPSS software (version 18). Quantitative and qualitative results were reported as mean±standard error and percentage, respectively. The obtained findings indicated a significant association between the location of foot ulcers and the risk of osteomyelitis (P=0.02); accordingly, osteomyelitis is more likely to occur in diabetic ulcers on the toes. However, no significant difference was observed between right and left foot ulcers in terms of osteomyelitis risk. Mean erythrocyte sedimentation rate was also significantly higher in diabetic patients with osteomyelitis than those of non-osteomyelitis ones (P=0.04). However, no significant difference was observed in C-reactive protein and leukocytosis. The age and gender of the patients had no significant effect on the risk of osteomyelitis. Overall, the results of the present study demonstrated a significant relationship between the location of foot ulcers and the probability of osteomyelitis. Accordingly, ulcers located on the toes are more likely to develop osteomyelitis.

Diabetes is one of the chronic diseases that can disrupt the quality of life of patients with its vascular problems and physical and psychological complications. The chronic complications of this disease, including diabetic foot ulcers, add to the importance of self-care treatment in this disease, which has a profound effect on the quality of life of patients. For this reason, the participation of patients in the treatment process is essential. One of the most important treatments for these patients is the use of participatory care model. The present study was conducted as a clinical test with the aim of determining the effect of implementing a participatory care model on quality of life in patients with diabetic foot ulcers hospitalized to Taleghani Hospital of Urmia.

In this random clinical study, 60 eligible patients were randomly selected from available population and assigned to intervention and control groups.During the first session, for both groups, the standard questionnaires of quality of life of patients suffering from diabetic foot ulcer as well as demographic questionnaires were completed. The program for implementing the participatory care model was held face to face and pamphlet for the intervention group (including steps: motivation, preparation, engagement, evaluation) for seven sessions each for an hour. Three months after the completion of the partnership program, both groups completed the questionnaire again.

Based on the findings, the mean scores of quality of life and its dimensions (except for the economic component) between both intervention and control groups after the implementation of participatory care model were different (p <0.001). Also, the mean scores of quality of life and its dimensions (except for the components of daily activity, life satisfaction, and economic situation) within the intervention group after implementing the participatory care model increased significantly related to that before the intervention (p <0.001).

The implementation of participatory care model is effective in improving the quality of life of patients with diabetic foot ulcers. Therefore, it is recommended that nurses, encourage the patients in self-care along with assessing their needs and abilities, to prevent the occurrence and progression of diabetes complications and reduce treatment costs.

Self-care not only reduces patientschr('39') hospitalization but also prevents their various problems. Therefore, this systematic review and meta-analysis aimed to evaluate the self-care behaviors of diabetic foot prevention in patients with diabetic foot ulcers.

The present systematic review study was conducted on studies performed on the application of the self-care model of diabetic foot prevention in patients with diabetic foot ulcers. To access the articles, detailed research was carried out on Google Scholar, SID Iran Doc, Iran Medex, and Magiran databases, and the search process was performed using the following Persian keywords: "Self-care", "Self-care frame", and "Diabetic foot ulcers". Moreover, English databases, namely Web of Sciences, PubMed, ProQuest, Google Scholar, Scopus, and Science Direct, were searched using the English keywords of "Diabetic foot" and "Self-care". All English and Persian articles performed 2001-2020 were included. At the end of this stage, seven articles were selected aligned with the purposes of this study, reviewed by two members of the research team separately regarding their quality, and confirmed and analyzed using the Consolidated Standards of Reporting Trials tool in terms of their quality.

Out of the reviewed articles, 7 articles were included in the study, including 1 (14%) and 6 (86%) articles published in English and Persian, respectively. Regarding the research place, two articles were conducted in Urmia, Iran, and five articles were performed in Tehran, Saveh, Yazd, Shahrekord, and Torbat Heydariyeh, Iran. The results of studies generally emphasized the effectiveness of training on the evaluation of self-care behaviors and its effect on diabetic wound healing.

It is suggested that due to the chronic nature of diabetes, high prevalence of foot ulcers in patients with diabetes, and high costs of healthcare for these wounds, self-care programs developed based on standard methods be used as safe, non-pharmacological, non-invasive, and inexpensive methods in controlling physical and psychological problems.

Diabetes is one of the most common metabolic diseases in the world, of which one of the most common and painful complications is diabetic foot ulcer. The accuracy and comprehensiveness of the contents of electronic medical record is effective in improving the quality of treatment and the care of diabetic foot ulcer patients. The aim of this study is to determine the minimum data set(MDS) essential for diabetic foot patientschr('39') electronic medical records.

In this descriptive-analytical study, authoritative internet and library resources were studied to collect diabetic foot ulcer information elements. Fourteen physicians and nurses working and collaborating with the Wound Healing Center affiliated to Academic Center for Education, Culture and Research(ACECR) were selected for clinical survey, and 5 health information technology specialists of Tehran University of Medical Sciences(TUMS) were chosen for demographic information survey. The study tools were a researcher-made questionnaire, CVR content validity method and test-retest method for reliability. 

Out of 23 information elements surveyed in demographic section, cases above 99% of the agreement were selected. Also, out of 86 information elements of the clinical section, more than 51% of the cases were selected. Clinical experts included 6 wound specialists, 4 general practitioners and 6 nurses. In the demographic information section, the lowest agreement was related to the element of identity and Education level with 20% agreement. In clinical information, the lowest agreement was related to surgery, leech therapy and MRI of the foot with 0% and PRP, G-CSF, Sono-Doppler liver with 14%.

The minimum information elements of diabetic foot ulcer electronic medical record were divided into history, wound information, lower limb information, paraclinical results, wound management, and follow-up in clinical section; and in demographic information section,  they were divided into identity, admission, finance, reporting, and system capability. The proposed model for manual and electronic medical records is available.

Diabetic foot ulcer (DFU) is one of the common reasons for non-traumatic amputation of the lower limbs, which requires proper diagnosis, proper collection of specimens, careful selection of antibiotics, treatment of infection based on the disease condition, quick decision about whether or not surgery is necessary and other types of wound care. Probiotics are suggested as non-pathogenic microorganisms due to antibiotic resistance in the treatment of DFU. The effects of probiotics on immune function, skin diseases, and diabetes have been studied and recent evidence suggests their effect on DFU through controlling hyperglycemia, improving immune function, and modulating the microbiota as possible mechanisms. In this review article, we discuss the role of probiotics in healing chronic infected wounds of the diabetic foot from several perspectives including the role of microbiota in glycemic control, the effect of probiotics on the immune system, inflammatory markers, wound healing acceleration, and infection control. Topical application and oral intake of probiotics, especially when used as adjunctive therapies with antibiotics, seems to facilitate the healing process of infected diabetic foot ulcers.

The Pender’s health promotion model is a framework used for determining health-promoting lifestyle behaviors in people with chronic diseases. This study aims to investigate the effect of educational intervention based on the Pender’s health promotion model on the lifestyles of patients with diabetic foot ulcers.

In this clinical trial conducted in 2019, 74 patients were selected based on inclusion criteria by convenience sampling and allocated into two groups, the intervention and control, using the randomized block method. Both groups completed the demographic characteristics- and the Health-Promoting Lifestyle Profile Questionnaires. Data obtained were analyzed using SPSS 16, using descriptive & comparative statistical methods, including independent t-test, paired t-test and ANCOVA.

After the intervention, a significant increase was observed in the average score of the intervention group in all lifestyle dimensions (P<0.001). Comparing the changes in the average scores of lifestyle and its dimensions in both groups 50 days after the intervention, an increase was observed in the average scores of lifestyle and its dimensions in the intervention group, compared to those in the control group (P<0.001).

Educational intervention based on the Pender’s health promotion model can promote the lifestyles of patients with diabetic foot ulcers, results of which can be used in educational interventions aimed at patients with diabetic foot ulcers to change their lifestyles.

Peripheral neuropathy is one of the most common problems in diabetic patients. The increased risk of Diabetic Foot Ulceration (DFU) and amputation would be a complication of diabetic neuropathy. The aim of this study was to compare the DFU healing in different severity classification of neuropathy.

This is a retrospective study that was conducted over a two-year period from April 2016 to March 2018 according to the information of patients records with Diabetes Mellitus (DM) referred to clinic of diabetes and metabolic disorders of Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences. Wound healing criteria including area, depth and healing duration were studied. Accordingly, changes in the area and depth of wounds were evaluated and reported during the first, third and sixth months after baseline. Data were analyzed using descriptive and inferential statistics using SPSS software version 16.

The results of the study of patients with neuropathic ulcer showed that males and age group of 56 to 65 years had the highest frequencies. In addition, most of these patients suffered from type 2 DM (79%). The rate of wound healing, which was measured by area and depth of wound in three time periods, differed in different severity classification of neuropathy; at mild level of neuropathy the area and depth of wound decreased faster but in severe neuropathy, duration of wound healing in both mentioned criteria has increased. Regarding to the increase in the duration of DM, the healing time increased too. However the rate of wound healing decreased with increased age (p-value = 0.001).

Evidence suggests that early identification of neuropathy can reduce the incidence of DFU and amputation. Due to the slow healing of the size and depth of the wound in diabetic patients with severe neuropathy, it is necessary to prevent DFU by conducting preventive care and educational interventions.

Diabetic foot ulcer is a serious complication of diabetes mellitus; it consists of lesions in the deep tissues associated with neurological disorders and peripheral vascular disease in the lower limbs. Delayed wound healing in diabetes leads to long-term hospitalization and even amputation of distal organs. Diabetes mellitus is associated with decreased nitric oxide bioavailability that causes dysfunction of the skin. Nitric oxide, a short-lived free radical, is produced in the skin, where it has important physiological functions. Much evidence suggests that nitric oxide accelerates wound healing. This review describes the pathways of nitric oxide production in the skin as well as role of nitric oxide donors in diabetic wound healing. Increased oxidative stress and arginase activity contribute to decreased nitric oxide bioavailability in diabetes. Based on data available, nitric oxide donors such as nitrite increase nitric oxide levels in the diabetic wound and improve would healing. It seems that increased nitric oxide in diabetic patients improves wound healing by increased collagen deposition and keratinocytes proliferation in the wound edges there by increasing reepithelialization capacity, chemoattractant of cytokines, increased formation of small blood vessels and increased blood flow to the wound site. In conclusion, nitric oxide donors could be considered as a potential and cost-effective treatment for diabetic wounds.

Diabetic foot ulcer is one of the most common problems in diabetic patients, hospitalized in infectious ward. Given various side effects of many antibiotics, the precise determination of the type of antibiotic used with the least side effects has great clinical importance. In this regard, the present study was conducted to compare the effectiveness of injectable levofloxacin with that of injectable ciprofloxacin and clindamycin in the treatment of leg ulcer infection in diabetic patients, hospitalized in the infectious ward. This research was conducted on 46 patients with grade 2 diabetic leg ulcer in two groups of 23 patients, including a group treated with injectable levofloxacin (mono-therapy) and a group treated with combination of injectable ciprofloxacin and clindamycin (combined therapy). Blood and tissue samples were collected for serological and microbiological studies. Then, important treatment parameters, including reduction in oxidative secretion, pathogenic activity of the ulcer, reduction in the number of inflammatory cells duration of treatment, and cost of treatment and other cases were studied in two groups. All isolated bacteria were Gram positive and Staphylococcus species had the highest frequency. The level of reduction in oxidative secretion, the pathogenic activity of diabetic leg ulcer, and the reduction in the number of inflammatory cells in the ulcer in the mono-therapy group increased more than that in combined therapy. The rate of increase in tissue debridement and shrinkage of ulcer surface of diabetic patients were also higher in the mono-therapy group.
The rate of recovery in the ulcer of the diabetic patients was similar in both groups. The duration of antibiotic therapy in the mono-therapy group was reduced by 22.8% in mono-therapy group in comparison to that in the combined treatment group, which this difference was clinically highly significant. In clinical evaluations, the success and cost of treatment in the group treated with levofloxacin as mono-therapy were better than those in the group treated with combinition of ciprofloxacin and clindamycin.

For nearly 100 years, amniotic membranes have been used to treat various types of skin wounds. Amniotic extract is one of the derivatives of amniotic membrane that contains all the properties of amniotic membrane. The aim of this study was to evaluate the safety of the amniotic membrane extract in the treatment of diabetic ulcers. This study was an Open labeled clinical trial without control group. A total of 10 patients with Wagner Grade 2 diabetic foot ulcers were selected in both sexes. The extract was used every 48 hours in the first week and every 72 hours from the second week until the end of the wound treatment. Patients were followed up weekly until wound healing. In this study 80% of patients were men and 20% were women with mean age (56.7 ± 8.7) years. The ulcer duration was 8.9 ± 2.12 weeks. The mean area of ulcers at the time of entry into the wound group ≥ 500 mm2, 977.5 ± 201.9 and in the wound group ≤500 mm2 was 145.6 ± 36.4. At 4 weeks post treatment, the wound healing rate in the wound group was ≤500% ,98.9 ± 2.40 % and in the wound group ≥mm2 500 was 92.1 ± 7.23%. in sixth week of treatment, ulcers were complete closure  in both groups. The results of this study suggest that the use of amniotic extract can be effective in the healing of diabetes foot ulcer without any side effects.

Diabetic foot ulcers, which are complications of diabetes mellitus, can be accompanied by an infection in the wound, which can increase the risk of amputation or even death. E coli bacteria, which have been reported to be present in diabetic foot ulcers, can lead to worsening of the condition of the wound. The aim of this study was to detect β-lactamase genes in Escherichia coli isolated from diabetic foot ulcer by Multiplex PCR in Jahrom city. Determination of antibacterial sensitivity of Escherichia coli isolated using disc diffusion method. The detection of strains producing ESBL enzymes was performed using Double disk synergy test. In order to detect carbapenem resistant organisms in the TSF, the concentration of 0.5 McFarland was used. To isolate and identify MBL-producing strains, the Etest MBL (AB BioDisk, Solna, Sweden) tapes was used according to the manufacturer's instructions. In a multiplex PCR assay, using specific primers, the presence of genes encoding beta-lactamase enzymes including blaTEM, blaSHV and blaOXA-1 was studied.

Diabetic foot ulcers, which are complications of diabetes mellitus, can be accompanied by an infection in the wound, which can increase the risk of amputation or even death. E coli bacteria, which have been reported to be present in diabetic foot ulcers, can lead to worsening of the condition of the wound. The aim of this study was to detect β-lactamase genes in Escherichia coli isolated from diabetic foot ulcer by Multiplex PCR in Jahrom city. Determination of antibacterial sensitivity of Escherichia coli isolated using disc diffusion method. The detection of strains producing ESBL enzymes was performed using Double disk synergy test. In order to detect carbapenem resistant organisms in the TSF, the concentration of 0.5 McFarland was used. To isolate and identify MBL-producing strains, the Etest MBL (AB BioDisk, Solna, Sweden) tapes was used according to the manufacturer's instructions. In a multiplex PCR assay, using specific primers, the presence of genes encoding beta-lactamase enzymes including blaTEM, blaSHV and blaOXA-1 was studied.

Diabetes is a chronic disease that is accompanied by some complications, such as diabetic foot ulcers, which account for 50,000-60,000 amputations annually. The non-treatment of the complications caused by these ulcers would result in significant costs. Regarding this, the present study aimed to compare the effectiveness of platelet rich plasma (PRP) dressing with that of normal saline dressing in the improvement of diabetic wounds
Materials and Methodgy: This clinical trial was conducted on 60 diabetic patients with grades 1 and 2 diabetic foot ulcers based on Wagner classification, who referred to Shahid Beheshti Hospital in Kashan, Iran. After the collection of the demographic data, the patients were visited by an infectious disease specialist and entered in the study in case of meeting the inclusion criteria. Subsequently, the participants were randomly assigned into two groups of PRP and normal saline dressing. The two groups were examined in terms of the depth and area of the wound at the beginning and end of the first, second, and third weeks of the intervention. The data were analyzed using Fisher’s exact test, Chi-square test, and t-test.
Out of the 60 patients referring to Shahid Beheshti Hospital, 10 patients were excluded from the study. Therefore, the study was continued with 50 patients divided equally into two groups. According to the results, 45 males had type 2 diabetes mellitus, and the rest suffered from type 1 diabetes. The mean disease duration was 12.78±6.76 years. Furthermore, 41 and 9 patients received insulin injections and oral medications, respectively. The mean glycosylated hemoglobin and fasting blood glucose were 12.28±0.98 and 232.66 mmol/L, respectively, which were not statistically different between the two groups at the beginning of the study. However, there was a significant difference between the study groups at the end of the first, second, and third weeks in terms of the area and depth of wound. .
As the findings indicated, PRP dressing was more effective in improving the diabetic foot ulcer as compared to the normal saline dressing As the findings indicated, PRP dressing was more effective in improving the diabetic foot ulcer as compared to the normal saline dressing.

Drug discovery based on traditional medicines is called reverse pharmacology. During investigation of traditional medicine, there are two categories of diseases: The first, diseases such as constipation which they could be partially or fully matched in conventional and traditional medicine. The second, diseases such as diabetic foot ulcer (DFU) that, there is no direct mention about them in the context of traditional medicine. The aim of this study was to prioritize the materia medica utilized in Persian medicine for treatment of ghorooh (wounds) and using a reverse pharmacology approach to develop new effective drugs for DFU.
In this library study, on the first level, different types of ghorooh were searched and collected in four references of traditional medicine and then, these data were rated into two groups based on similarity with the main symptoms of DFU: Ghorooh with symptoms closed to DFU and ghorooh with symptoms away from DFU. In later levels, different materia affecting ghorooh were scored based on repetition in sources and scientists emphasis. Lastly, adding the scores of the two levels, acquired data was ranked in term of effect on DFUs.
Myrtle, Frankincense, Plantain, Aloe Vera and Chinese lantern had highest scores. Finally, the myrtle fruits suggested for preparing the best formulation drug for DFU.
For use of traditional knowledge in modern diseases, first, we must establish a logical connection between conventional and traditional medicine. Then, prioritization of effective materia medica and reverse pharmacology could lead to production of new effective drugs for DFU.

Type 2 diabetes is the most common type of diabetes, and a complex endocrine metabolic disorder that one of its main complications is diabetic foot ulcers. Matrix metalloproteinases (MMPs) are one of the key enzymes in the reconstruction of extracellular matrix which have proteolytic activity. The aim of this research is based on evaluating relationship between -1562 C>T allele at MMP-9 gene promoter with diabetic foot ulcer in type II diabetic patients. If such correlation proves, it can be used as a prognostic biomarker in patients with high-risk.
This is a case-control study. The single nucleotide polymorphism of -1562C>T allele of MMP9 gene promoter was genotyped by hit Tetra ARMS PCR technique in 100 diabetic patients with foot ulcer grade 1 or 2 as the case group according Wagner classification and in 100 diabetic patients without foot ulcer as the control group.
The Chi-square test revealed significant difference in genotype frequency of CC, CT and TT alleles of -1562C>T allele of MMP9 gene promoter between case and control groups (P=0.000).
According to this study, there is a relationship between -1562C>T allele of MMP9 gene promoter with diabetic foot ulcer in type2 diabetes patients. Thus we can introduce this biomarker for evaluation of risk and prognosis of diabetic foot ulcers.

Type 2 diabetes is a metabolic disorder characterized by high blood sugar levels that can damage nerves. Many organs are affected ¡especially the foot that leading to loss of sensation. These factors make favorable conditions for the development of diabetic foot ulcers. Polymorphisms (Thr399Ile) of Toll Like Receptor4 (TLR4) gene due to malfunction of TLR4 protein which plays an important role in immunity. The purpose of this study was to determine the parameters which are affecting the imbalance resulting in chronic inflammation and wound healing. By showing the relationship between single nucleotide polymorphism (Thr399Ile) of TLR4 gene with diabetic foot ulcer we can identify a biomarker for prediction of diabetic foot ulcer.
This is a case-control study. Single nucleotide polymorphisms of TLR4 gene were genotyped by hit Tetra ARMS PCR technique. In this study, 100 and 120 diabetic patients with and without foot ulcer were selected as the cases and controls, respectively.
The Chi-square test revealed significant difference in frequency of TT, CC and TC alleles of (Thr399Ile) between case and control groups (P=0.021).
According to this study, there is a relationship between single nucleotide polymorphisms (Thr399Ile) of TLR4 gene with diabetic foot ulcer in type 2 diabetes patients