Evaluating the Effect of the Different Diabetic Control's Methods Including Tight Control on the Healing Response of Diabetic Foot Ulcer Treated with Low Level Laser Therapy (LLLT)

Abstract

INTRODUCTION: Low-level laser therapy (LLLT) is shown effective in healing diabetic foot ulcer when combined with conventional therapy. Since; Diabetes mellitus is a leading cause of impaired wound healing. The aim of this study is to determine the effect of different diabetic control’s methods on the healing response of diabetic foot ulcer in those patients treated with Low level laser therapy (LLLT), added to conventional therapy.METHODS: This study contains 74 diabetic foot-ulcers which most of them prone to resistance to conventional therapy. Different stages of diabetic foot ulcers and ways of controlling blood glucose level are included in this study. There were 3 response groups; Group 1-Insulin receiving patients, most of them had a very tight blood glyceamic level profile controlling. Group 2- Non-insulin receiving or drug dependent patients, had a periodical blood glyceamic level profile with flatuance. Group 3- Mixed methods. Most of the patients in this group had tight blood glyceamic level profile controlling. The way to control blood glucose level should be according to the internist`s consult. The wounds irradiation are performed by the combination of infra-red and red, (860 nm and 650 nm) laser, with the total energy density of 3.6 J/cm² in addition of intravenous laser therapy (IVL) with 2.5 MW, 650 nm (red) laser used for 30 minutes. All wounds have been photographed from equal distance, before and after treatments, and all the wounds were staged by a surgeon who was neutral about the effects of the laser therapy. The surgeon’s judgment was established only by the visual assessments of the wounds. All the mathematical and statistical analysis is based on the descriptive statistics using the software package SPSS16.CONCLUSION: LLLT promote the tissue repair process of diabetic foot ulcer. Healing response of the patients was not dependent on methods of controlling blood glucose level. Previously it was reported that tight control of diabetes containing continuous subcutaneous insulin infusion and others on split mixed doses promotes healing of diabetic foot lesions. In this study; we found interruption of LLLT in the treatment of diabetic wound; can give a very acceptable result even in the absence of tight controlling of glucose level. When the quantity presentations value of the mean blood glucose level distribution was on the range of 144- 275 mg/dl. In this multi-disciplinary method we achieved a remarkably shorter mean healing time of two months, compared with other reported studies with healing time of three to six months.