Gruzmark Fiona S, Beraja Gabriela E, Jozic Ivan, Lev-Tov Hadar A
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Wound Repair Regen. 2025 Sep-Oct;33(5):e70085. doi: 10.1111/wrr.70085.
Globally, there are 537 million people with diabetes, with an estimated 19%-344% of these people developing a diabetic foot ulcer, and 10% dying within a year of being diagnosed with a diabetic foot ulcer. Risk factors for developing a diabetic foot ulcer include age, sex, ethnicity, chronically elevated HbA, smoking history, cardiovascular disease, end-stage renal disease, and retinopathy. Diabetic foot ulcer recurrence rates are as high as 20%, and they have vast complications, including lower-extremity amputations. More recently, there has been a surge in the use of glucagon-like peptide 1 receptor agonists in managing diabetes and weight loss. The use of glucagon-like peptide 1 receptor agonists in treating diabetic foot ulcers in humans has not been extensively studied, but there are reports of using glucagon-like peptide 1 receptor agonists in other dermatologic diseases with positive outcomes, including androgenetic alopecia and hidradenitis suppurativa. This review aims to explore the potential of using systemic glucagon-like peptide 1 receptor agonists in managing diabetic foot ulcers, describing their effects on modulating wound repair, microvascular function, neuropathic symptoms, apoptosis, weight loss, oxidative stress, and inflammation. Additionally, a systematic review, following PRISMA guidelines, was conducted assessing the rate of diabetic foot complications in patients using glucagon-like peptide 1 receptor agonists when compared to a control group, with the results suggesting their potentially protective role. By managing multiple facets of diabetic foot ulcer pathophysiology, the use of glucagon-like peptide 1 receptor agonists may aid in their management and thus prevent recurrence.
全球范围内,有5.37亿糖尿病患者,其中估计有19% - 344%的人会发生糖尿病足溃疡,10%的人在被诊断为糖尿病足溃疡后的一年内死亡。发生糖尿病足溃疡的风险因素包括年龄、性别、种族、长期升高的糖化血红蛋白、吸烟史、心血管疾病、终末期肾病和视网膜病变。糖尿病足溃疡的复发率高达20%,并且会引发大量并发症,包括下肢截肢。最近,胰高血糖素样肽1受体激动剂在糖尿病管理和减肥方面的使用激增。胰高血糖素样肽1受体激动剂在治疗人类糖尿病足溃疡方面尚未得到广泛研究,但有报道称在其他皮肤病中使用该激动剂取得了积极成果,包括雄激素性脱发和化脓性汗腺炎。本综述旨在探讨全身性使用胰高血糖素样肽1受体激动剂在管理糖尿病足溃疡方面的潜力,描述其对调节伤口修复、微血管功能、神经病变症状、细胞凋亡、体重减轻、氧化应激和炎症的影响。此外,按照PRISMA指南进行了一项系统评价,评估了使用胰高血糖素样肽1受体激动剂的患者与对照组相比糖尿病足并发症的发生率,结果表明其可能具有保护作用。通过管理糖尿病足溃疡病理生理学的多个方面,使用胰高血糖素样肽1受体激动剂可能有助于其管理,从而预防复发。
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