On diabetic foot, wound healing, amputation prevention, and the merger of consumer tech with medical devices
Three new papers converge on a two-cent idea: the neutrophil percentage-to-albumin ratio (NPAR) measures the balance between inflammatory injury and nutritional reserve — tracking both how bad the diabetic foot is now and how the patient fares over years. Plus a clear-eyed look at why AI-driven precision nutrition isn't here yet, and what it will take.
Windy Cole and colleagues propose a master-protocol basket trial that borrows oncology's tissue-agnostic playbook for hard-to-heal wounds — testing a single mechanism-targeted therapy across diabetic foot and venous leg ulcers under one Bayesian, sham-controlled design. We've spent a decade framing the diabetic foot like cancer; here, the trial architecture grows up to match.
The World Cup isn't the only global tournament underway. Thanks to Anica Badanjak and Anela Novak's new Croatian translation, the IWGDF Guidelines now reach patients in a native language on every inhabited continent on Earth — every single one.
A guest essay by Dr. Lucian Feraru. As ambient scribes and AI engines learn to write the note, summarize the chart, and flag the risk, the physician's job quietly changes — from author to auditor. Feraru argues the next real clinical skill is not generation but verification, and warns against a bargain in which the machine gets the speed, the doctor gets the liability, and the patient gets whatever slips through the gap.
Twenty-seven years ago I propped my two-year-old on an exam chair at the Texas Diabetes Institute. This week, in the same clinic room, same chair, same clock, she graduated chief resident, trained by my former fellow Lee Rogers, my research partner Larry Lavery, and the legendary Bob Frykberg. A note on three generations, the team approach, and the giants who raised my daughter into this profession.
A new Science Robotics study from Northwestern and the Shirley Ryan AbilityLab virtually couples a therapist's and a stroke survivor's exoskeletons so they feel each other's movements in real time — turning "walk a mile in your patient's shoes" into an actual control law, with a clear path toward home-based, remote gait rehab.
Two diabetic foot data engines published the same day on two continents. STEADY (US) is a 5,000-patient, AI-enabled real-world registry; DARE-DiaFoot (Italy) is a deep, multi-instrumental phenotyping protocol that quietly studies remission. One is the census, the other the core sample. Together with EURODIALE, the U.S. Wound Registry, and the National Diabetes Foot Care Audit, they sketch a blueprint for finally measuring what we manage.
A new paper in BMC Health Services Research describes how we co-created a Foot Selfie app with, not for, people living with diabetes, caregivers, and clinicians in urban Lima and semi-rural Piura, Peru. Here is how the end-users redesigned remote diabetic foot surveillance to fit the rooms where it actually happens.
Notes from the Beaumont Multidisciplinary Diabetic Foot Symposium in Dublin (18 June 2026) — a true toe-and-flow gathering across vascular surgery, podiatry, endocrinology and infectious diseases, where the watchword was remission, not cure.
A new multi-omics preprint uses Mendelian randomization to argue that six circulating miRNAs causally regulate peripheral artery disease in the diabetic foot—and flags metformin as the most translationally tractable repurposing candidate. A nice piece of computational scaffolding, with the usual in-silico caveats.
