Advancing Diabetic Foot Care

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Cleveland Clinic has an active program of innovation and research in the area of diabetic foot care. Some recent publications from our group are listed below.

Our research is supported by the National Institutes of Health, the Juvenile Diabetes Research Foundation, by major corporations and by private donors. To learn more about opportunities for contributing toward this research, please call 216.445.6980 and ask for Dr. Peter Cavanagh, academic director of the Diabetic Foot Care Program.

Our research programs in diabetic foot complications are located in the Cleveland Clinic Lerner Research Institute’s Department of Biomedical Engineering. Researchers pursue a wide variety of studies, including mathematical modeling of the foot, imaging of the foot muscles in people with diabetic neuropathy, studying the mechanical characteristics of skin, designing optimal footwear for reducing pressure under the foot, and determining the properties of diabetic bone.

Cleveland Clinic researchers are conducting a number of studies of the circulation that relate to diabetes. Many studies focusing on other diabetic complications are also in progress. For information on becoming part of our research program as a study volunteer; please call 216.445.3555 to speak with our diabetes nurse educator.

Current Clinical Trials:

Study Title: A Multi-Center, Double Blind, Randomized, Parallel, Vehicle and Standard Care Controlled, Dose Ranging Study Assessing the safety and Efficacy of MRE0094 Gel When Applied Topically for 90 Days to Subjects with Diabetic Neuropathic Foot Ulcers.

Purpose: To test the effectiveness and safety of a topical drug on the healing of open foot ulcers

Eligibility Criteria: 18-85 years old, Type I or Type II Diabetes, Open ulcer on the bottom of your foot

Contact: Georgeanne Botek D.P.M., 216.445.8152

Study Title: Pivotal Study to Evaluate the Efficacy and Safety of Dermal-Living Skin Replacement (Dermal-LSR) in the Treatment of Chronic Diabetic Foot Ulcers.

Purpose: To test the efficacy and safety of a topical product combined with the standard of care treatment to heal diabetic foot ulcers compared to standard of care treatment alone

Eligibility Criteria: 18-85 years old, Type I or Type II Diabetes, Ulcer on the bottom of your foot

Contact: Georgeanne Botek D.P.M., 216.445.8152

Publications:

Jeffcoate WJ, Game F, Cavanagh PR. The role of proinflammatory cytokines in the cause of neuropathic osteoarthropathy (acute Charcot foot) in diabetes. Lancet. 2005 Dec 10;366(9502):2058-61.

Cavanagh PR , Lipsky BA, Bradbury AW, Botek G . Treating diabetic foot ulcers. Lancet 2005, Nov 12;366(9498):1725-1735.

Petre, M. , Tokar, P. , Kostar, D. and Cavanagh, P. (2005) Revisiting the total contact cast: maximizing off-loading by wound isolation, Diabetes Care, 28: 929-930.

Erdemir, A. , Saucerman, J. J., Lemmon, D., Loppnow, B., Turso, B., Ulbrecht, J. S. and Cavanagh, P. (2005) Local plantar pressure relief in therapeutic footwear: design guidelines from finite element models, Journal of Biomechanics, 38: 1798-1806.

Goske, S., Erdemir, A. , Petre, M. , Budhabhatti, S. and Cavanagh, P. (2005) Reduction of plantar heel pressures: insole design using finite element analysis, Journal of Biomechanics (in press 2005 Sep 27; [Epub ahead of print]).

Erdemir, A., Viveiros, M. L., Ulbrecht, J. S. and Cavanagh, P. (2005) An inverse finite element model of heel pad indentation, Journal of Biomechanics (in press May 17; [Epub ahead of print]).

Romito, E. and Cavanagh, P. (2005) Plantar pressure during barefoot walking: implications for footwear design and clinical screening, submitted to the Journal of Biomechanics.

Budhabhatti, S., Erdemir, A., Petre, M. and Cavanagh, P. (2005) Finite element modeling of the first ray of the foot: a tool for the design of interventions, submitted to Journal of Biomechanical Engineering.

Petre, M, Erdemir, A. and Cavanagh, P. (2005) Determination of elastomeric foam parameters for simulations of complex loading, submitted to Computer Methods in Biomechanics and Biomedical Engineering.

Bus, S. A., Ulbrecht, J. S. and Cavanagh, P. (2004) Pressure relief and load redistribution by custom-made insoles in diabetic patients with neuropathy and foot deformity, Clinical Biomechanics,19: 629-638.

Cavanagh, P. (2004) Can therapeutic footwear help protect the insensate diabetic foot? Intl Diabetes Monitor, 16:10-16.

Cavanagh, P. (2004) Therapeutic footwear for people with diabetes, Diabetes Metab Res Rev., 20: S51-S55.

Ulbrecht, J. S. and Cavanagh, P. (2004) Shoes and insoles for at-risk people with diabetes, Chapter in a monograph for the American Diabetes Association.

Erdemir, A., Hamel, A. J., Fauth, A. R., Piazza, S. J. and Sharkey, N. A. (2004) Dynamic loading of the plantar aponeurosis in walking, Journal of Bone and Joint Surgery, 86-A: 546-552.

Davis, B., Kuznicki, J., Praveen, S., Sferra, J. (2004). Lower-extremity amputations in patients with diabetes: pre- and post-surgical decisions related to successful rehabilitation. Diabetes/Metabolism Research and Reviews, v20, May-Jun; Suppl 1:S45-50.

Perry, J., Hall, J.O., Davis, B. (2002) Simultaneous measurement of plantar pressure and shear forces in diabetic individuals. Gait and Posture, 15(1): 101-107.

Kao, P., Davis, B., Hardy, P. (1999) Characterization of the calcaneal fat pad in diabetic and non-diabetic patients using magnetic resonance imaging. Magnetic Resonance Imaging, 17(6): 851-857.

Davis, B., Perry, J., Neth, D., Water, K. (1998) A device for the simultaneous measurement of pressure and shear forces on the plantar surface of the foot. Journal of Applied Biomechanics, 14: 93-104.