This just published by our team in concert with William Jeffcoate of Nottingham, Andrew Boulton and Loretta Vileikyte of Manchester and Ed Boyko of University of Washington.
In particular, note Table 3, which provides a 21 point checklist for development and audit of randomized controlled trials in the diabetic foot.
via Current Challenges and Opportunities in the Prevention and Management of Diabetic Foot Ulcers. – PubMed – NCBI
This study is very interesting. The right questions are asked. But, we do not have all the answers. I want to emphasize one thing, the study tells us that for often, the wounds come back after healing but, it is normal. This is understandable. Injuries are caused by hyperglycemia when the skin is dry and hyperkeratosis. The pressure has nothing to do with shoes, clothes, nor with any external element. And, to decrease the pressure by the vascularization is not useful. When the sugar increases, it will always have pressure, It is a wave of keratinocyte that undergoes receives a call to multiply the proliferation, as there is already congestion in the epithelial tissue new born should go up and that the skin is dry and hyperkeratosis there is pressure and there is a skin tear, where it is weaker. When you cut the foot, the problem just moves elsewhere and the person will die in 1 to 5 years. If you apply my treatment, and you cause the keratinocytes to migrate normally from the base to the cornea in 20 days, the keratinocytes will be able to have yime to integreat keratohyalin usefull for healing wounds and be able to develops the elements (SCTE and SCCT) for the destruction of the last layer of the cornea, at the right time and place. This is the missing map of everything you have already found. An Easy and cheap solution for all poor countries.