# Management of the Diabetic Foot in People with Diabetes Mellitus Older than 65 Years
## 3 Results
In general, they claimed to comply more with the indications related to medications before other practices. Foot self-care was largely underrecognized [17]. In the article by [PERSON], it was observed that 92.3% had not tested their blood sugar in the last week, 3% measured their blood sugar for three days and 4.7% measured their blood sugar for one or two days. Moreover, 25% did not practice a diet, 39.3% did not practice physical activity even once day and 80.4% had not performed foot care on a single day in the last week [18]. In the study by [PERSON], after 10 sessions, a significant reduction in the lesion surface with complete healing was observed. After completing 20 sessions, healing was obtained in 70% of the patients, while 25% suffered amputations due to the extension of tissue necrosis and bone infection due to poor vascular status and significant metabolic alteration [19]. In the article by [PERSON], 53% of the patients received 30 sessions, of which 24% were referred more than once for the treatment of a diabetic foot ulcer, which indicates that the sessions were temporarily separated by two or more THOB cycles. A total of 40% complied with the treatment protocol. The median survival was 4.6 years, and the cumulative mortality was 1 and 5 years (14.2%) [20]. In the study by [PERSON], wounds treated with THOB and routine care after 10 sessions showed signs of healing. Within 20 sessions, the state of the wounds began to show clear improvements. Two weeks after therapy, they improved even more. Wounds treated with only routine care showed little change and early deterioration [21]. In the article by [PERSON], a clinical case of a patient with DFU with HBOT is presented. Following this therapy, the wound healed completely 2 months after starting therapy [22]. In these three studies, it was observed that 100 of the patients had arterial hypertension, 47 patients had cerebrovascular disease, 69 nephropathy and 55 others. In the [PERSON] study, patients with DM2 were treated with TPWT. In the TPWT group (those with noninfected neuropathic ulcers of area \(>\) 1 cm\({}^{2}\) on one foot), the duration of the wound was 21.1 \(\pm\) 24.7 weeks, and in the comparison group (those with ulcers of area \(\leq\) 1 cm\({}^{2}\) or Bilateral SLE) it was 14.4 \(\pm\) 14.3 weeks. Regarding the wound area, the TPWT group was 15.7 \(\pm\) 14.6 cm\({}^{2}\) and the comparison group 2.9 \(\pm\) 4.4 cm\({}^{2}\). The reduction in wound area after 8 days was 1.1 \(\pm\) 1.7 and 0.3 \(\pm\) 0.7 cm\({}^{2}\). However, the reduction in wound area after 8 days (\(\%\)) was 10.2 \(\pm\) 14.41 and 18.0 \(\pm\) 15.7. Complete resolution of the ulcer occurred in one year in the NPWT group, 55.1%, and in the comparison group, 73.7%. On the other hand, the appearance of the ulcer occurred a year after its complete resolution, 29.2% and 31.3%. Major amputations did not occur in the TPWT group and only one in the comparison group. Finally, as for the deceased, in the TPWT group there was three and in the comparison group two [23]. The [PERSON] et al. study is a retrospective analysis in which patients are treated at home with TPWT. Cure of the ulcer was observed in 61% of the patients. An additional split skin graft treatment was required in 8.5%, debridement in 8.5%, minor amputation in 9.3% and major amputation in 20.3%. The death rate was 0.9%. The need for VAC extension (negative-pressure-assisted closure) was observed in 8.5%. An unplanned readmission of 30 days was observed in 14.8%. Lastly, a one-year survival rate was observed in 89% [24]. In the article by [PERSON], a systematic review in which the Cochran library, Medline, Embase, Ovid and Chinese Biological medicine databases were searched, the following results were obtained. Compared to standard dressings, TPWT had a higher rate of complete ulcer healing, shorter healing time and a greater reduction in ulcer depth. The amputation rate was lower. It also had no incidence of treatment-related adverse effects [25].