New clinical research program takes steps to predict and prevent diabetic foot ulcers

More than 100 million adults in the United States live with diabetes or prediabetes, according to the Centers for Disease Control and Prevention. Most people know that common complications of the disease include increased thirst, weight loss and fatigue.

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But fewer may know about another side effect: diabetic foot ulcers, which affect nearly 25 percent of individuals and are one of the disease's most prevalent complications. Patients with ulcers can't put weight on the affected area in order to facilitate healing (and avoid infection).

Still, those ulcers are responsible for about 80,000 nontraumatic amputations nationwide each year — surgery that comes with a five-year mortality rate of up to 40 percent. 

And after decades of decline, those amputations appear to be on the rise, says Rodica Pop-Busui, M.D., Ph.D., a professor of internal medicine and associate chair of clinical research at the University of Michigan.

"This is extremely revealing because it shows that numbers are growing despite significant advances in both targeted wound care and the overall improvement of medical care for patients with diabetes," she says.

Treatment and surgery for diabetic foot ulcers cost Americans up to $13 billion annually, demonstrating this complication's significant economic impact.

That's what led Pop-Busui and her U-M colleagues to conceive and open a diabetic foot research clinic. The unit, known as the Diabetes Foot Consortium, will examine all facets of diabetic foot ulcerations research, treatment and prevention when it opens at the end of October.

A step in the right direction

In a collaborative effort, U-M researchers obtained a grant from the National Institutes of Health to launch the research unit. The university was one of only six academic institutions selected for funding for this project.

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"Receiving funding from the NIH for this project was very exciting," Pop-Busui says. "It opened the doors for us to continue our research within a dedicated network of experts and truly make strides in the advancement of care for diabetic foot ulcers."

The consortium will be composed of a highly skilled clinical research team and other contributing staff members across all six institutions. The U-M team is led by James Wrobel, D.P.M., Brian Schmidt, D.P.M., Crystal Holmes, D.P.M., and Pop-Busui.

Researchers will work to identify, analyze and validate the best biomarkers and predictors of outcomes for diabetic foot ulcers. By evaluating the visible and invisible aspects of the condition, clinic staff ultimately hope to develop the premise for innovative therapies to better treat these ulcers and prevent limb loss.

"Through several forms of macroscopic evaluation, clinicians will be able to examine the spatial features of diabetic wounds and their surrounding areas, and in turn, better predict wound healing," Pop-Busui says. "This is very exciting."