Review Article
Application of Polysaccharide Hydrogel Loaded Mesenchymal Stem Cell Exosomes in Diabetic Wound Repair Research Progress
Issue:
Volume 10, Issue 4, December 2025
Pages:
78-84
Received:
18 September 2025
Accepted:
29 September 2025
Published:
29 October 2025
Abstract: The impaired healing of diabetic wounds is a key factor leading to foot ulcers, wound gangrene, and even amputations in patients. Mesenchymal stem cell exosomes offer a novel therapeutic strategy for diabetic wound repair; however, exosomes are easily cleared by the immune system in vivo and have a short retention time in tissues, resulting in suboptimal therapeutic efficacy. Polysaccharide-based hydrogels are ideal delivery carriers for exosomes. This article analyzes the causes of difficult diabetic wound healing, provides a brief overview of the applications of mesenchymal stem cell-derived exosomes and polysaccharide-based hydrogels in diabetic wound healing, and discusses the role of polysaccharide-based hydrogels loaded with exosomes in promoting diabetic wound healing. This work aims to provide a reference for the application of exosome-loaded polysaccharide-based hydrogels in diabetic wound repair.
Abstract: The impaired healing of diabetic wounds is a key factor leading to foot ulcers, wound gangrene, and even amputations in patients. Mesenchymal stem cell exosomes offer a novel therapeutic strategy for diabetic wound repair; however, exosomes are easily cleared by the immune system in vivo and have a short retention time in tissues, resulting in subo...
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Review Article
Healthcare Economics and Policy in Diabetic Foot Care
Anand Shankar*
Issue:
Volume 10, Issue 4, December 2025
Pages:
85-97
Received:
12 September 2025
Accepted:
25 September 2025
Published:
31 October 2025
Abstract: Background: Diabetic foot ailment is a severe and multifaceted complication of diabetes mellitus that imposes significant scientific, economic, and societal burdens worldwide. Its high prevalence, coupled with complications such as ulcers, infections, and amputations, contributes substantially to morbidity, mortality, and reduced quality of life. Aim: This chapter aims to examine diabetic foot care through the perspectives of health-care economics and policy, highlighting the global burden, associated costs, and strategies to improve outcomes. Methods: The chapter reviews epidemiological data on diabetic foot disease, analyses the economic burden including direct medical expenses, productivity losses, and psychosocial impacts and critically appraises health-economic evaluations such as cost-effectiveness and cost-utility studies. Policy analysis is conducted to explore international and national strategies, regulatory frameworks, and reimbursement mechanisms. Care models, including multidisciplinary teams, community-based programmes, telemedicine, and integrated care pathways, are also assessed. Results: Findings reveal considerable regional variation in disease burden, risk factors, and economic costs. Evidence supports the value of preventive measures, multidisciplinary clinics, and advanced wound-care technologies in improving health outcomes and cost efficiency. However, persistent gaps remain, including inequitable access to care, underfunding, workforce shortages, and socioeconomic disparities. Conclusions: A comprehensive, integrated approach is essential to effectively address diabetic foot disease. Strengthening preventive efforts, adopting innovative technologies, ensuring universal health coverage, and implementing data-driven policies can reduce the global burden, improve patient outcomes, and achieve cost-efficient, equitable care.
Abstract: Background: Diabetic foot ailment is a severe and multifaceted complication of diabetes mellitus that imposes significant scientific, economic, and societal burdens worldwide. Its high prevalence, coupled with complications such as ulcers, infections, and amputations, contributes substantially to morbidity, mortality, and reduced quality of life. A...
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Research Article
Development of a Composite Performance Score Tool for Diabetes Mellitus Management: Features and Framework
Issue:
Volume 10, Issue 4, December 2025
Pages:
98-106
Received:
12 October 2025
Accepted:
12 November 2025
Published:
9 December 2025
Abstract: Background: Type 2 diabetes mellitus (T2DM) remains a critical public health challenge in low- and middle-income countries (LMICs), where existing assessment tools often fail to integrate the full spectrum of clinical, behavioral, and contextual determinants of care. This study developed and validated the Management Performance Composite Scoring Tool (MPCST), a multidimensional instrument designed for primary healthcare (PHC) settings, grounded in the Chronic Care Model (CCM). Methods: An exploratory sequential mixed-methods design was conducted over four months across five public PHC facilities in Nairobi, Kenya. The qualitative phase involved six focus group discussions (n=52) and ten key informant interviews to identify domains relevant to T2DM management. In the quantitative phase, 181 adults with stable T2DM were selected via systematic random sampling. Data collection employed validated instruments alongside standardized clinical and biochemical assessments. A composite scoring algorithm was developed using statistical machine learning and deployed in a Streamlit-based application for real-time clinical utility. Psychometric validation included content validity (Lawshe’s method), generalizability theory, and convergent and concurrent validity analysis. Results: Among 181 participants (63.5% female; mean age 55.9 years), glycemic control was poor (mean HbA1c: 9.39 mmol/L), and lifestyle performance was suboptimal. Tool development incorporated clinical (e.g., HbA1c, BMI), behavioral (diet, activity, distress), and contextual (social determinants, healthcare access) domains. Ordinal regression yielded excellent model fit (pseudo R² = 0.949, AIC = 69.821). Geometric mean aggregation improved behavioral sensitivity, while minimax strategies optimized clinical indicator selection. The MPCST demonstrated high reliability (G = 0.8351), strong convergent (r = 0.74) and concurrent (r = 0.565) validity. Conclusion: The MPCST is a rigorously validated, contextually relevant, and scalable tool for evaluating T2DM care quality in LMIC PHC systems. Its dual-format (manual and app-based) design supports routine use, longitudinal tracking, and integration into health systems, thereby enhancing clinical decision-making and patient-centered care.
Abstract: Background: Type 2 diabetes mellitus (T2DM) remains a critical public health challenge in low- and middle-income countries (LMICs), where existing assessment tools often fail to integrate the full spectrum of clinical, behavioral, and contextual determinants of care. This study developed and validated the Management Performance Composite Scoring To...
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