Abstract
Charcot neuroarthropathy (CN) is a devastating condition affecting the feet in patients with diabetes. The pathophysiology of (CN) is still incompletely understood, although main etiological components have been identified. The cornerstone of treatment of acute CN is immediate effective offloading, typically with total contact casting, and reduction in weight-bearing. The main current targets of pharmacological intervention are the inhibition of excess osteoclast activation and suppression of an excess pro-inflammatory cytokine response. Anti-resorption therapy, especially with bisphosphonates, has been used in randomized trials. The trials so far have demonstrated improved symptom control, a more rapid decline in foot temperature and a significant decrease in bone turnover markers. An understanding of the molecular pathways of bone resorption will help in the development of novel adjunctive pharmacological therapies which might further improve the outcome in patients with CN.
Keywords: Diabetes mellitus, Charcot foot, Neuropathy
Current Diabetes Reviews
Title:The Diabetic Charcot Foot
Volume: 8 Issue: 3
Author(s): Sanjay U. Dissanayake, Frank L. Bowling and Edward B. Jude
Affiliation:
Keywords: Diabetes mellitus, Charcot foot, Neuropathy
Abstract: Charcot neuroarthropathy (CN) is a devastating condition affecting the feet in patients with diabetes. The pathophysiology of (CN) is still incompletely understood, although main etiological components have been identified. The cornerstone of treatment of acute CN is immediate effective offloading, typically with total contact casting, and reduction in weight-bearing. The main current targets of pharmacological intervention are the inhibition of excess osteoclast activation and suppression of an excess pro-inflammatory cytokine response. Anti-resorption therapy, especially with bisphosphonates, has been used in randomized trials. The trials so far have demonstrated improved symptom control, a more rapid decline in foot temperature and a significant decrease in bone turnover markers. An understanding of the molecular pathways of bone resorption will help in the development of novel adjunctive pharmacological therapies which might further improve the outcome in patients with CN.
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Cite this article as:
U. Dissanayake Sanjay, L. Bowling Frank and B. Jude Edward, The Diabetic Charcot Foot, Current Diabetes Reviews 2012; 8 (3) . https://dx.doi.org/10.2174/157339912800563981
DOI https://dx.doi.org/10.2174/157339912800563981 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
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