Diabetic Foot Ulcers and Placental Cells

What is a diabetic foot ulcer?

Diabetic foot ulcers (DFU) represent one of the most common complications suffered by people with diabetes.[1] A DFU is an open wound or sore on the skin that is slow to heal, which can have a profound impact on the morbidity, mortality and quality of life of patients.

The high blood sugar levels associated with diabetes can damage nerves and blood vessels over time, causing the blood supply to the feet to become significantly restricted. As a result, the feet receive a lower number of infection-fighting cells, which can lead to longer healing time.

Even a small cut or burn could lead to ulcers and infections. If a wound or sore becomes infected as a result of slow recovery time, there is a high risk that Gangrene could occur –  a serious condition whereby a loss of blood supply causes body tissue to die.[2] If this happens, the patient may need surgery to remove the damaged tissue and in severe cases, the toe or foot may need to be amputated.

Diabetic Foot Ulcer Facts

• 7 million people in the UK have diabetes
• 10% of people with diabetes have a diabetic foot ulcer
• The number of people diagnosed with diabetes has more than doubled in 20 years.
• Someone is diagnosed with diabetes every two minutes.
• More than 4 in 10 people who have a foot ulcer will die within five years.
• Studies suggest that between 70,000 and 90,000 people with diabetes have a foot ulcer in any given week.
• Every week, diabetes leads to more than 169 amputations.
• The NHS spends over £192 million a week on diabetes.

Diabetic Foot Ulcers and Placental Cells: Developments

Individuals suffering from diabetes need to take extra care of their feet. Diabetic foot ulcers continue to have high treatment costs and have now become a major global public health issue. Current conventional treatments for DFU include medicine, physical therapies and surgery. These therapies often require a long-term hospital stay yet despite this, difficulties still remain which make it unlikely for the wound to completely heal.[4]

However, stem cell therapy is currently being investigated as a potential new interventional method to treat DFU, with an increasing number of successful preclinical and clinical trials taking place. In recent years, placenta-derived mesenchymal stem cells have shown particularly promising results in DFU treatment research. This is due to placenta cells being multipotent, meaning they have the ability to produce and release a variety of regenerative growth factors which promote wound healing, which is crucial for DFU.

In 2017, a single-patient case study was completed which assessed the efficacy and safety of placenta cells in wound repair and improving the rate of wound healing. The patient present in the study suffered from type 2 diabetes and a 20-day FCU, with conventional therapies having no effect on the foot.

As part of the treatment, the patient received placenta cells as a topical wound treatment for a period of three weeks. Researchers reported that, in this specific instance, to the placenta cells’ potential regenerative and healing abilities, the patient’s foot ulcer was completely healed after 3 weeks. The patient recovered function in their foot and the ability to walk with no relapse in the six months following the treatment.

Numerous other studies suggest that placenta cells have the potential to play a significant part in the prevention and treatment of DFU in the future. These cells offer the potential for accelerating wound healing, reducing infection and preventing re-ulceration – providing a potentially life-changing option for diabetic patients in the future.

Although the application of placental tissue for wound healing is still undergoing clinical evaluation rather than being a routine hospital procedure, banking this tissue at birth simply helps keep your options open as regenerative medicine continues to explore new ways to support those with diabetes.

References

• NHS, Complications of Peripheral Neuropathy, accessed 21 October 2019, <https://www.nhs.uk/conditions/peripheral-neuropathy/complications/>
• NHS, Gangrene Overview, accessed 21 October 2019, <https://www.nhs.uk/conditions/gangrene/>
• Diabetes UK, ‘Us, diabetes and a lot of facts and stats’, accessed 21 October 2019, <https://www.diabetes.org.uk/resources-s3/2019-02/1362B_Facts%20and%20stats%20Update%20Jan%202019_LOW%20RES_EXTERNAL.pdf>
• Xiagnxia Zeng, MS., et al., (2017). ‘Three-week topical treatment with placenta-derived mesenchymal stem cells hydrogel in a patient with diabetic foot ulcer’, Medicine (Baltimore), 95, (51), pp. 1-4, accessed 21 October 2019,
  <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758170/>
• Lopes, Lara, et al., (2018). ‘Stem cell therapy for diabetic foot ulcers: a review of preclinical and clinical research’, Stem Cell Research Therapy, pp. 1-16 accessed 21 October 2019, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042254/>.
• Podiatry Today, ‘A Closer Look At The Role Of Amniotic Membrane For Diabetic Foot Ulcers’, accessed 21 October 2019, <https://www.podiatrytoday.com/closer-look-role-amniotic-membrane-diabetic-foot-ulcers>

The information contained in this article is for information purposes only and is not intended to replace the advice of a medical expert. If you have any concerns about your health we urge you to discuss them with your doctor.