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Diabetic foot ulcer treatment using prophylactic heart disease drugs cuts deaths

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Giving prophylactic heart disease drugs to patients with diabetic foot ulcers can significantly reduce mortality, a Scottish study has found.

According to a team from the Royal Infirmary of Edinburgh, a simple system of heart monitoring combined with preventative medicine could save the lives of thousands of patients with diabetic foot ulcers.

The researchers studied 250 patients diagnosed with a diabetic foot ulcer between 2001 and 2004.

Every patient underwent a full cardiovascular assessment including checks on blood pressure, cholesterol and heart function.

All patients were then started on a combination of drugs to target heart disease – including aspirin, statin therapy, ACE inhibitors and beta-blockers – even if they had no history of cardiovascular illness.

The researchers then compared the mortality rate of this group with a control group of around 400 diabetic patients who were diagnosed with a foot ulcer between 1995 and 1999, and who did not receive the trial package of care.

The four-year mortality rate was cut by half in the experimental group – the mortality rate was 43.3% in the control group and 21.9% in the intervention group – the authors reported online in Diabetes Care.

Lead researcher Matthew Young, consultant physician at the hospital, said the programme should be rolled out across the UK.

‘If this was repeated across Scotland, it would prolong the lives of thousands of patients and tens of thousands in the UK as a whole,’ he said.

‘This is a very exciting study showing reduced mortality in diabetic foot patients receiving full cardiovascular protection,’ said Audrey Edmonds, lead diabetic foot nurse specialist at King’s College Hospital NHS Foundation Trust in London. ‘The results are impressive.’

Liesl Richardson, senior diabetes specialist nurse at Norfolk and Norwich University Hospitals NHS Foundation Trust, also welcomed the findings.

‘Anything that can be done prophylactically to help reduce the risk of further deterioration is beneficial to the patient,’
she said.

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