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30th January 2024 Latest News

New clue to treating diabetic foot ulcers

Robert Fitridge 2

A type of protein commonly linked to lowering the risk of heart disease could hold fresh clues for treating poor wound healing in people with diabetes, an Adelaide study has shown.  

The study, made possible by a grant from The Hospital Research Foundation Group, has shown for the first time that the anti-inflammatory function of high-density lipoproteins (HDL) is linked to poor wound closure.  

Led by University of Adelaide’s Prof Robert Fitridge and A/Prof Christina Bursill, the team found that HDL’s function in patients with Type 1 diabetes was weaker than in healthy patients.  

Prof Fitridge, also a vascular surgeon at Royal Adelaide Hospital and The Queen Elizabeth Hospital, said that measuring HDL functionality could be used as a biomarker to predict how wounds might heal for diabetics.  

“We already know that HDL is linked to cardiovascular outcomes, but there are only a few studies showing its links to wound healing,” he said.  

“What our study focused on was the functionality of patients’ HDL, or in simple terms how good it was at doing what HDL does. This would be the first potential biomarker for predicting wound closure in patients with diabetes, and possibly even those without diabetes.”  

Higher levels of HDL, often referred to as ‘good cholesterol’, have been shown to lower the risk of developing cardiovascular disease but it also helps to reduce inflammation.  

A previous study linked low levels of HDL-cholesterol to amputations in patients with diabetic foot ulcers, but emerging evidence shows that measuring HDL’s functionality is a better predictor.  

In Australia, it is estimated that about 50,000 people are affected by diabetes-related foot ulcers, and 40% of those develop an infection within five years of the ulcer developing.  

About 85% of all amputations in Australia are associated with diabetes-related foot ulcers.  

“Patients with diabetes-related foot ulcers can have some of the worst health outcomes of any cohort at the hospital, and having additional measures and treatments is critical to healing these often-chronic open wounds,” Prof Fitridge said.  

The findings of this study could ultimately help clinicians more effectively manage diabetics with low functioning HDL through methods that promote better wound healing.  

Prof Fitridge said the results of the study left the team in a good position to advance to clinical trials in the future.  

He said this could include targeted treatments like applying HDL directly to the wound.