This is not the most recent version of the article. View current version (13 JAN 2016)

Intervention Protocol

You have free access to this content

Intensive versus conventional glycaemic control for treating diabetic foot ulcers

  1. Malindu E Fernando1,2,*,
  2. Ridmee M Seneviratne1,
  3. Margaret Cunningham1,
  4. Peter A Lazzarini3,4,
  5. Kunwarjit S Sangla5,
  6. Yong Mong Tan5,
  7. Petra G Buttner6,
  8. Jonathan Golledge1,7

Editorial Group: Cochrane Wounds Group

Published Online: 11 OCT 2013

DOI: 10.1002/14651858.CD010764

How to Cite

Fernando ME, Seneviratne RM, Cunningham M, Lazzarini PA, Sangla KS, Tan YM, Buttner PG, Golledge J. Intensive versus conventional glycaemic control for treating diabetic foot ulcers (Protocol). Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD010764. DOI: 10.1002/14651858.CD010764.

Author Information

  1. 1

    School of Medicine and Dentistry, James Cook University, Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, Townsville, Queensland, Australia

  2. 2

    Kirwan Community Health Campus, Department of Podiatry, Townsville, Queensland, Australia

  3. 3

    Queensland Health, Allied Health Research Collaborative, Herston, Brisbane, Queensland, Australia

  4. 4

    Queensland University of Technology, School of Clinical Sciences, Brisbane, Queensland, Australia

  5. 5

    The Townsville Hospital, Department of Diabetes and Endocrinology, Townsville, Queensland, Australia

  6. 6

    James Cook University, School of Public Health and Tropical Medicine, Townsville, Queensland, Australia

  7. 7

    The Townsville Hospital, Department of Vascular and Endovascular Surgery, Townsville, Queensland, Australia

*Malindu E Fernando, Department of Podiatry, Kirwan Community Health Campus, Townsville, Queensland, Australia.

Publication History

  1. Publication Status: New
  2. Published Online: 11 OCT 2013


This is not the most recent version of the article. View current version (13 JAN 2016)


Additional references

ADA 2012
  • American Diabetes Association. Standards of medical care in diabetes 2012. Diabetes Care 2012;35(suppl 1):11-63.
Apelqvist 1999
  • Apelqvist J, Larsson J. What is the most effective way to reduce incidence of amputation in the diabetic foot?. Diabetes/Metabolism Research and Reviews 1999;16(Suppl 1):75-83.
Armstrong 1998
  • Armstrong D, Lavery D C, Harkless L. Validation of a diabetic wound classification system - the contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 15th January 1998;21(5):855-9.
Bagg 2001
Boulton 2004
Brownlee 2004
Burakowska 2006
  • Korzon-Burakowska A, Edmonds M. Role of the microcirculation in diabetic foot ulceration. International Journal of Lower Extremity Wounds 2006;5(3):144-8.
Cheung 2009
  • Cheung NW, Conn JJ, d’Emden MC, Gunton JE, Jenkins AJ, Ross GP, et al. Position statement of the Australian Diabetes Society: individualisation of glycated haemoglobin targets for adults with diabetes mellitus. Medical Journal of Australia 2009;191:339–44.
Christman 2011
Clayton 2009
  • Clayton WJr, Elasy TA. A review of the pathophysiology, classification, and treatment of foot ulcers in diabetic patients. Journal of Clinical Diabetes 2009;27(2):52-8.
Cook 2012
  • Cook JJ, Simonson DC. Epidemiology and health care cost of diabetic foot problems. In: Veves A editor(s). The Diabetic Foot: Medical and Surgical Management. Boston: Contemporary Diabetes, 2012:17-32.
D'Souza 2009
  • D'Souza DR, Salib MM, Bennett J, Mochin-Peters M, Asrani K, Goldblum SE, et al. Hyperglycemia regulates RUNX2 activation and cellular wound healing through the aldose reductase polyol pathway. Journal of Biological Chemistry 2009;284(27):17947-55.
Daroux 2010
  • Daroux M, Prévost G, Maillard-Lefebvre H, Gaxatte C, D’Agati VD, Schmidt AM, et al. Advanced glycation end-products: implications for diabetic and non-diabetic nephropathies. Diabetes and Metabolism 2010;36:1-10.
Delamaire 1997
Dinh 2005
  • Dinh TL, Veves A. A review of the mechanisms implicated in the pathogenesis of the diabetic foot. International Journal of Lower Extremity Wounds 2005;4(3):154-9.
Electronic Therapeutic Guidelines Australia 2012
  • ETG. Type 2 diabetes and cardiovascular disease risk. Australian Electronic Therapeutic Guidelines 2012; Vol. Accessed 10th December 2012.
Falanga 2005
Game 2012
Geraldes 2010
Giacco 2010
Gupta 2010
  • Gupta SK, Panda S, Singh SK. The etiopathogenesis of the diabetic foot: an unrelenting epidemic. The International Journal of Lower Extremity Wounds 2010;9(3):127 –31.
Hemmingsen 2011a
  • Hemmingsen B, Lund SS, Gluud C, Vaag A, Almdal T, Hemmingsen C, et al. Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials. BMJ 2011;343:
Hemmingsen 2011b
Higgins 2011a
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Available from
Higgins 2011b
  • Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from
Hinchliffe 2012
  • Hinchliffe RJ,  Andros G,  Apelqvist J,  Bakker K,  Friederichs S,  Lammer J, et al. A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease. Diabetes/Metabolism Research and Reviews 2012;28(Suppl 1):179-217.
Hogg 2012
  • Hogg FR, Peach G, Price P, Thompson MM, Hinchliffe RJ. Measures of health-related quality of life in diabetes-related foot disease: a systematic review. Diabetologia 2012;55(3):552-65.
IDF 2012
  • International Diabetes Federation. IDF diabetes atlas update 2012. The global burden. (accessed 10 December 2012).
Idris 2005
Ikem 2010
  • Ikem R, Ikem I, Adebayo O, Soyoye D. An assessment of peripheral vascular disease in patients with diabetic foot ulcer. Foot 2010;20(4):114-7.
Inzucchi 2012
  • Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Journal of Diabetes Care 2012;35(6):1364-79.
Jeffcoate 2004
Jones 2007
  • Jones RN, Marshall WP. Does the proximity of an amputation, length of time between foot ulcer development and amputation, or glycemic control at the time of amputation affect the mortality rate of people with diabetes who undergo an amputation?. Advances in Skin & Wound Care 2008;21(3):118-23.
Lefebvre 2011
  • Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from
Ma 2009
  • Ma J, Yang W, Fang N, Zhu W, Wei M. The association between intensive glycemic control and vascular complications in type 2 diabetes mellitus: a meta-analysis. Nutrition, Metabolism, and Cardiovascular Diseases: NMCD 2009;19(9):596-603.
Macisaac 2011
Mattila 2010
  • Mattila TK, de Boer A. Influence of intensive versus conventional glucose control on microvascular and macrovascular complications in type 1 and 2 diabetes mellitus. Drugs 2010;70(17):2229-45.
Mazzone 2010
Moher 2009
  • Moher D, Liberati A, Tetzlaff J, Altman DG for the PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:332-6. [b2535. doi: 10.1136/bmj.b2535]
Nathan 2012
  • Nathan DM. Understanding the long-term benefits and dangers of intensive therapy of diabetes. Archives of Internal Medicine 2012;172(10):769-70.
NCCH 2006
  • National Centre for Classification in Health. The Australian Classification of Health Interventions (ACHI) 5th edition- Tabular list of Interventions and alphabetic index of interventions. The University of Sydney, Faculty of Health Sciences 2006.
Ogbera 2008
  • Ogbera OA, Osa E, Edo A, Chukwum E. Common clinical features of diabetic foot ulcers: perspectives from a developing nation. International Journal of Lower Extremity Wounds 2008;7(2):93-8.
Rafehi 2010
Robbins 2008
  • Robbins JM, Strauss G, Aron D, Long J, Kuba J, Kaplan Y. Mortality rates and diabetic foot ulcers: is it time to communicate mortality risk to patients with diabetic foot ulceration?. Journal of the American Podiatric Medical Association 2008;98:489-93.
Schaper 2004
  • Schaper NC. Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies. Diabetes/Metabolism Research and Reviews 2004;20(Suppl 1):S90–5.
Schaper 2012
Shenoy 2012
  • Shenoy AM. Guidelines in practice: treatment of painful diabetic neuropathy. Continuum Lifelong Learning in Neurology 2012;18(1):192-8.
SIGN 2012
  • Scottish Intercollegiate Guidelines Network (SIGN) Guidelines. Search filters. 2012:accessed (10 December 2012).
Singh 2005
Stegenga 2008
  • Stegenga ME, van der Crabben SN, Blümer RM, Levi M, Meijers JC, Serlie MJ, et al. Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia. Blood 2008;112(1):82-9.
Stratton 2000
  • Stratton IM, Adler AI, Neil AW, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-12.
Tesfaye 2012
Thomson Reuters 2012
  • Thomson Reuters. Endnote. 2012; Vol. Accessed 10th July 2013.
UKPDS 1998
  • UKPDS. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352(9131):837-53.
Wu 2007
  • Wu SC, Driver VR, Wrobel JS, Armstrong DG. Foot ulcers in the diabetic patient, prevention and treatment. Journal of Vascular Health Risk Management 2007;3(1):65-76.