[The diabetic foot. The Croatian model--national consensus (clinical recommendations for diagnosis, prevention and therapy)]. / Dijabeticko stopalo. Hrvatski model--nacionalno usuglaseno misljenje (klinicke preporuke za dijagnostiku, prevenciju i lijecenje).

Diabetic foot occurs due to the loss of protective sense and circulation disorder and a marked proneness to infections. Mechanical stress of bone growths frequently leads to ulcerations. The prevention and timely treatment of diabetic foot requires the participation of both patients and all health care levels. This consensus is given for the purpose of procedure standardization. Education is the basis of prevention and should be carried out with every patient suffering from diabetes mellitus and those with a sensory defect in particular. Appropriate footwear significantly contributes to prevention and treatment of ulcers. As regards the treatment, the necessity of surgical approach with a long term and often manifold antibiotic therapy should be pointed out. Infections are usually mixed. The deeper the ulceration, the more likely the infection with anaerobes and Gram-negative bacteria occurs in addition to Gram-positive ones which are normally present in surface lesions. Strict metabolic control is a precondition for successful treatment. In conclusion, diabetic foot is a major health problem which requires multidisciplinary approach with permanent patient education as its essential part, and a specific cooperation of all levels and different health care specialties.

[Treatment of hemodynamic disorders of the peripheral arteries in a diabetic]. / Lijecenje poremecene hemodinamike u perifernim arterijama kod dijabeticnih bolesnika.

The experiences of the authors in treatment of disturbed haemodynamics in peripheral arteries in diabetics, as well as their complications have been here presented. The increased frequency of these disturbances, as well as pathologic changes on the parts of lower extremities in diabetics, regarding prolonged age and always better detection in new cases of diabetes have been presented in the introduction. Etiopathogenic causes and clinical picture and symptomatology of the mentioned cases are briefly described. In diagnosis particular significance has been given to all standard examination methods, and in indicated cases angiologic, respectively contrast investigations are necessary. In surgical treatment of such patients, the causes of the respective disturbances should be established first and only then therapeutic principles should be applied. The presentation of the treated patients has been given, and it has been considered in the conclusion that the team work in treatment of the mentioned disturbances is necessary.

Effect on platelet adhesiveness in diabetics after long-term treatment with a new oral hypoglycaemic agent, gliclazide.

Gliclazide is an oral hypoglycaemic agent which has been shown in animal models to reduce platelet adhesiveness. In this study, 50 patients with maturity onset diabetes treated with gliclazide (80 mg/day) were followed up for 6 months to 1 year to assess the effect on platelet adhesiveness and control of blood sugar. A significant fall in mean platelet adhesiveness from 29% before treatment to 19.5% after 1 year (p less than 0.001) was achieved without any deleterious effect on normal haemostasis. The drug was well tolerated and achieved a satisfactory control of blood sugar levels at the dosages used.