Posts for: February, 2015
How effective is orthotic treatment in patients with recurrent diabetic foot ulcers?
We assessed the efficacy of customized foot orthotic therapy by comparing reulceration rates, minor amputation rates, and work and daily living activities before and after therapy. Peak plantar pressures and peak plantar impulses were compared with the patients not wearing and wearing their prescribed footwear.
One hundred seventeen patients with diabetes were prescribed therapeutic insoles and footwear based on the results of a detailed biomechanical study and were followed for 2 years. All of the patients had a history of foot ulcers, but none had undergone previous orthotic therapy.
Before treatment, the reulceration rate was 79% and the amputation rate was 54%. Two years after the start of orthotic therapy, the reulceration rate was 15% and the amputation rate was 6%. Orthotic therapy reduced peak plantar pressures in patients with reulcerations and in those without (P < .05), although a significant decrease in peak plantar impulses was achieved only in patients not experiencing reulceration. Sick leave was reduced from 100% to 26%.
Personalized orthotic therapy targeted at reducing plantar pressures by off-loading protects high-risk patients against reulceration. Treatment reduced the reulceration rate and peak plantar pressures, leading to patients' return to work or other activities.
The study conducted by researchers from the Mammalian Genetics Unit and Medical Research Council and published in the Journal of Obesity, found that having a significantly different sleep pattern at the weekend compared to during the week - known as "social jet lag" - could be harmful to the metabolism.
The researchers' hypothesised that frequent sleep pattern disturbance would negatively affect the body clock, which could disrupt the metabolism, increasing the risk of developing obesity and type 2 diabetes.
The hypothesis may have been correct: a correlation was observed between social jet lag and certain metabolic markers that indicate an increased risk of obesity-related disease, such as type 2 diabetes.
The research was conducted by analysing data from over 800 people. Researchers examined the height, weight, and waist circumference of participants, then asked them to answer questions about sleeping patterns.
Those who had as little as two hours extra sleep at the weekend generally had a higher body mass index, were more likely to be obese, and had an increased risk of type 2 diabetes.
The findings do not suggest that people deprive themselves of extra sleep at the weekend if they feel they need it. Sleep deprivation has been linked to depression, stress, and anxiety. It is more advisable to go to bed earlier during the week.
Moreover, the study does not prove that social jet lag causes obesity. Discovering links between the two is not the same as determining a cause-and-effect relationship.
Dr. Michael Parsons, lead author of the study, said: "Our research confirms findings from a previous study that connected people with more severe social jet lag to increases in self-reported body mass index, but this is the first study to suggest this difference in sleeping times can also increase the risk of obesity-related diseases."