Award for a project that studies the relationship between nocturnal breathing disorders and diabetic foot ulcers

The Catalan Diabetes Association has awarded Josep León, specialist physician of the Endocrinology and Nutrition Service of the Arnau de Vilanova University Hospital, the prize for the best Clinical Research Project for the study "Impact of nocturnal breathing disorders on the characteristics and evolution of foot ulcers in patients with diabetes". This award is part of the call for Clinical Research Assistance in Diabetes 2021 and was presented during the XIV Conference of the Catalan Diabetes Association, held in Reus on 16 and 17 June.

The aim of the project is to deepen the study of breathing disorders during sleep (TRS) and, especially, in the impact of periods of hypoxia (decreased oxygen in cells and tissues of the body) maintained and intermittent, as a prognostic factor in the healing of diabetic foot ulcers (UPD). As Josep León explains, "this line of research that studies the relationship between diabetes and sleep apnoea syndrome has been the focus of much of our group's work in recent years". Specifically, the study proposes to establish the prevalence of sleep apnoea in patients with UPD and to evaluate the association between the characteristics of nocturnal hypoxia with the characteristics of the ulcers (size, depth) and their evolution (healing time, recurrence or amputation).

"We believe that going deeper into these objectives will allow us to improve our knowledge of the mechanisms that produce a torpid evolution of UPD in certain patients," explains León, adding that "we are seeking to identify the prognostic factors of poor evolution of UPD, focusing on the nocturnal period, in which diabetes represents a risk factor for presenting a greater number of episodes of apnoea and severe hypoxia". This information will serve to personalise the therapeutic approach to UPD, and thus lay the groundwork for studying whether the diagnosis and treatment of sleep apnoea can improve its outcome and evolution.

"The achievement of positive results can establish the basis for a new approach to UPD, with early screening by Endocrinology services for sleep apnoea and the corresponding preferential referral to specialised units to initiate treatment. This way of acting would have to modify the current care guidelines, at the same time as opening the door to an improvement in the prognosis of UPD", he concludes.

Josep León is a member of the Obesity, Diabetes and Metabolism Research Group (ODIM) at the IRBLleida Biomedical Research Institute, led by Albert Lecube, head of the Endocrinology and Nutrition Service at the Arnau de Vilanova University Hospital.