Prevention of the first ulcer research group

The DFSG executive committee was inspired by Ernst Chantelau to focus not only on treatment and prevention of recurrent diabetic foot ulcers but on prevention of the very first ulcer.

Diabetic foot ulcer (DFU) is known to be a severe complication of Diabetes. Recurrence rate is high, leading to additional costs to health care providers and patients. 

Many efforts to reduce primary and recurrence rates have been seen, however, there are very few studies focusing on the prevention of the very first ulcer with the aim of preventing the DFU and its sequelae entirely. 

Furthermore, due to the difficulties in stratification of low-risk from moderate or high-risk patients, and the need to protect the foot, studies are often limited. Therefore there are very few proven DFU primary prevention programs and in turn there is paucity of information for their economic benefit. 

The DFSG decided to initiate a group of young academics/clinicians/scientists to work on the field of “Prevention of the First Ulcer” with the aim to define patients at risk and to evaluate the ulcer incidence in high-risk, middle and low risk group. 

The Board of DFSG agreed to call for applicants and support the project by connecting the young scientist with group of multi-disciplinary mentors with a profound understanding of the diabetic foot and to bring the group together a few times to meet eye to eye for maximum commitment and inspiration. 

In June 2018 five out of nearly 40 applicants have been selected, and the first meeting of the young scientist and their mentors took place at the DFSG meeting 2018 in Berlin

Since than the group meet with their mentors Bus, Edmonds, Jeffcoate and Trocha 2 to 4 times a year, wrote 3 grant applications, established and uses a cross european data base,  had oral  and poster presentations on national and international conferences and published data.

Awards

Best Young Investigator Session Award – Johan Roijker

9th International Symposium of the Diabetic Foot, The Hague, Netherlands (2023)

Publications

Trocha, A., Gontscharuk, V., Icks, A., & Jeffcoate, W. (2024). The value of loss of protective sensation in predicting a first ulceration of the foot in people with diabetes, Diabetic Medicine, 41(4), doi: 10.1111/dme.15241. Acknowledgement: Personal thanks to Prof. Dr. Ernst A. Chantelau, who was the initiator of this Study and of the First Ulcer Prevention Research group of DFSG. Open Access funding enabled and organized by Project DEAL.

 

External Validity and Predictive Power of the DIAFORA System for Predicting Lower-extremity Amputations in a Danish cohort. Prepared for submission.

 

Different characteristics  between people presenting with a first versus a recurrent diabetes-related ulcer. In draft.

 

Diabetes related foot ulcer characteristic differences between two European Countries. In draft.

Presentations

  • Oral Presentation (2023): Validation of IWGDF risk stratification for a first ever ulcer in a diabetic population with loss of protective sensation (9th International Symposium of the Diabetic Foot, The Hague, Netherlands)
  • Poster (2023) : First ever ulcer onset in a diabetic population with loss of protective sensation- is pain perception the game changer (9th International Symposium of the Diabetic Foot, The Hague, Netherlands)
  • Poster (2023) : Major differences in people with diabetic foot ulcers can be found based on clinical history and setting (9th International Symposium of the Diabetic Foot, The Hague, Netherlands)
  • Poster (2023): External validity and predictive power of the DIAFORA-score for predicting lower-limb amputations in a Danish cohort (9th International Symposium of the Diabetic Foot, The Hague, Netherlands)
  • Oral Presentation (2022): Population differences in diabetic foot ulcers across Europe: preliminary data from an international database. An update from the DFSG Research Group: Prevention of the First Ulcer (Diabetic Foot Study Group Conference, Bratislava, Slovakia)
  • Oral Presentation (2021): DFSG Prevention of the First Ulcer Study Group Update (Diabetic Foot Study Group Conference (virtual))
  • Oral presentation (2020): DFSG Prevention of the First Ulcer Study Group Update (Diabetic Foot Study Group Conference (virtual))

Session at DFSG 2021

The Prevention of the first ulcer group will give an update on the project during DFSG 2021.

Contact the research group

You can contact the Prevention of the first ulcer research group on ulcerprevention@dfsg.org

OUR

Obectives

HFUS

Introduction to High Frequency Ultrasonography

HFUS is a recently introduced diagnostic technique, which finds several applicationsin diverse clinical fields. It uses a range of frequencies higher than 20 MHz and provides a high spatial resolution, making this technique suitable for several clinical applications, such as imaging of skin, blood vessels, musculoskeletal anatomy, oral mucosa, and small parts.

Considering the many applications of HFUS in dermatology, we want to highlight its suitability in clinical evaluation of melanocytic lesions and non-proliferative diseases, which includes lichen sclerosus, morphea, sarcoidosis, hidradenitis suppurativa, chronic and acute wounds.

Moreover, HFUS may be useful in the evaluation of micro-vascularity, skin thickness modifications and skin structures modifications in systemic diseases (e.g., diabetes and Sjogren disease).