Type 2 Diabetes Clinical Trial
Official title:
Genetic Contribution to the Pathophysiology of the Charcot Foot in Qatari Patients With Diabetes
To assess the hypothesis that Charcot foot is associated with more vascular complications compared to matched diabetic patients without Charcot foot and to classify patients with Charcot foot according to the human genetic classification of the Qatari population.
Diabetes is a serious health issue for the Qatari population since approximately 1/5 of the
population has Type 2 Diabetes, which is 2-3 times higher than the world average. Although
much of the clinical studies of diabetes often focused on microvascular phenotypes such as
retinopathy and nephropathy, and macrovascular diseases presenting clinically as myocardial
infarction, stroke, and peripheral vascular disease, other rare complications such as Charcot
foot disease confer a significant burden in Qatar diabetic population, leading to decreased
life quality.
Charcot foot is estimated to affect 0.8% to 8% of diabetic populations. It occurs most
commonly in patients with diabetes complicated by severe peripheral neuropathy, often with
coexisting sympathetic denervation, causing increased blood flow to the foot and increased
bone resorption.
Uncontrolled and inappropriate inflammation leading to bone resorption and deformation has
been the hallmark of diabetic Charcot foot pathophysiology. There are two major theories that
provide the likely mechanism of the disease. The "neurovascular (French) theory" suggests
that increased blood flow, as a result of autonomic neuropathy, can lead to bone destruction
and mechanical debilitation. On the other hand, the "neurotraumatic (German) theory" argues
that the loss of protective sensation leads to unperceived injury and trauma in the insensate
foot. One can argue that the pathogenesis of Charcot neuro-arthropathy is most likely a
combination of these processes. For unknown reasons, Charcot foot is trigged only in some
susceptible individuals with diabetes.
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