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This study investigates if different diabetic treatment regimens affects diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a non-healing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics and outcome were collected. Non-healing wound was defined as major or minor amputation or those who didn't have complete healing until the last observation. Median age was 60.0 years (range: 31.1-90.1) and 58 cases (68.2%) were males. Twenty-four cases reached a complete healing (healing rate: 22.4%). Median follow-up period in subjects with classified as having chronic wounds was 6.0 months (range: 0.7-21.8). Insulin treatment was a part of diabetes management in 52 (61.2%) cases. Insulin therapy significantly increased the wound healing rate (30.3% [20/66 ulcers] vs. 9.8% [4/41 ulcers]) (P=0.013). In multivariate random-effect logistic regression model, adjusting for age, gender, smoking status, type of diabetes, hypertension, chronic kidney disease, peripheral arterial disease, oral hypoglycemic use, wound infection, involved side, presence of Charcot's deformity, gangrene, osteomyelitis on x-ray, and serum hemoglobin A1C levels, insulin treatment was associated with a higher chance of complete healing (beta±SE: 15.2±6.1, P=0.013). Systemic insulin treatment can improve wound healing in diabetic ulcers after adjusting for multiple confounding covariates. This article is protected by copyright. All rights reserved.

The aim of this study was to determine the knowledge and practice of foot care in people with type 2 diabetes. We carried out a cross-sectional study. A questionnaire was completed by 148 patients with type 2 diabetes in Tehran, Iran. Knowledge score was calculated and the current practice was determined. The mean knowledge score was 6.6 (standard deviation +/-3.0) out of a possible 16. Illiterate patients were the least knowledgeable (P= 0.008). Lack of adequate knowledge includes the following: 56% not aware of the effect of smoking on the circulation to the feet, 60% failed to inspect their feet and 42% did not know to trim their toenails. High risk practices including use of irritants to water (66.5%) and walking barefoot (62%). The results of this study highlight the patients' inadequate knowledge of self-care about their foot and lack of optimal podiatry service in Iran. These findings have implications for further evaluation, planning and management of patient care in diabetic foot disease.