On diabetic foot, wound healing, amputation prevention, and the merger of consumer tech with medical devices
We have been tracking the emerging science of the wound microbiome on this blog for well over a decade -- from Randy Wolcott's early observations on "misanthropic microbial communities" (2009), to our own work with Spichler, Hurwitz, and Lipsky on microbiology from Louis Pasteur to "CSI" (2015), to the microbiome in wound healing -- good,... Continue Reading →
A few weeks ago, we launched The ZIP Code Lottery — a data narrative showing how amputation rates in Los Angeles County track almost perfectly with poverty, not clinical severity. It struck a nerve. The response told us something important: people want to see the data, and they want it to be impossible to look... Continue Reading →
A new accelerometer-based study from Michigan and Oxford shows that moderate-to-vigorous physical activity is associated with significantly lower odds of diabetic peripheral neuropathy — with vigorous activity cutting the odds by 60%.
In 2009, California hospitals collectively documented 7,973 lower-extremity amputations in diabetic adults. Dr. Carl Stevens at Harbor-UCLA decided to ask a question most people in medicine had quietly avoided: where do these patients live? The answer, published five years later in Health Affairs, was the kind of finding that is simultaneously obvious in retrospect and... Continue Reading →
Vitamin D has been medicine for millennia — we just didn't know it. A tour through its history, its biology, and what the evidence now says about its role in diabetic foot ulcer healing.
A new study from our USC group shows Medicaid patients with diabetic foot ulcers face 18% higher odds of infection hospitalization and 72% higher odds of major amputation — despite being younger and having comparable comorbidity burden after matching. The data point to structural vulnerability, not biology.
Our new paper is out today in Diabetology, and I'm really proud of this one. It's a narrative review—co-authored with Bijan Najafi and Shervanthi Homer-Vanniasinkam—that traces the entire arc of offloading from the 1930s to right now. We called it "From Plaster to Pixels" because that's genuinely what's happened. From plaster-of-Paris casts in leprosy clinics... Continue Reading →
A landmark Singapore study of 2,798 patients shows podiatric care associated with 69% lower mortality and 26% better amputation-free survival in diabetic foot ulcers. Podiatrists don't just save limbs — they save lives.
Three decades of putting weird ideas together with weird people — now you can see and share the whole thing. 👉 Explore the DGA Research Constellation For more than three decades, I've had the pleasure of doing something that doesn't have a clear name. It doesn't fit neatly on a CV. There's no NIH study... Continue Reading →
We talk a lot about the big-ticket items in diabetic peripheral neuropathy (DPN)—glucose control, hemoglobin A1c, advanced glycation end products. But what about the stuff sitting quietly in your multivitamin? A new review from Ntoga and colleagues out of the Diabetic Foot Clinic at Democritus University of Thrace—working with collaborators at Aristotle University of Thessaloniki—makes... Continue Reading →
