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CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2025; 133(03): 120-132
DOI: 10.1055/a-2498-6826
Review

Does Improvement of Glycemic Control Cause Acute Charcot Foot in Patients with Diabetes?

Ole Lander Svendsen 
1   Department of Endocrinology, Copenhagen Diabetes Foot Center, Bispebjerg Frederiksberg University Hospital, Copenhagen, Denmark (Ringgold ID: RIN53166)
2   Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
,
Rasmus Bo Jansen
1   Department of Endocrinology, Copenhagen Diabetes Foot Center, Bispebjerg Frederiksberg University Hospital, Copenhagen, Denmark (Ringgold ID: RIN53166)
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Abstract

Objective

Recent studies have suggested that improved glycemic control in patients with diabetes may cause acute Charcot foot. To conduct a narrative review of studies investigating whether improved glycemic control in patients with diabetes causes acute Charcot foot.

Method

Publications found by searching PubMed, EMBASE, and Cochrane Library as well as reference lists of identified publications were reviewed.

Results

Very few publications were found, primarily consisting of case reports and case studies without control groups, documenting instances where cases of acute Charcot foot had been preceded by improved glycemic control. Recent large multicenter randomized placebo-controlled clinical trials of anti-hyperglycemic agents in patients with diabetes, where significant improvement of glycemic control occurred, have not reported incidences of acute Charcot foot.

Conclusion

There is so far no solid evidence to suggest that improvement of glycemic control in patients with diabetes causes acute Charcot foot.

Keywords

diabetes - Charcot foot - glycemic control


Publication History

Received: 06 August 2024

Accepted after revision: 02 December 2024

Article published online:
22 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Rogers LC, Frykberg RG, Armstrong DG. et al. The Charcot foot in diabetes. Diabetes Care 2011; 34: 2123-2129
    CrossrefPubMedSearch in Google Scholar
  • 2 Svendsen OL, Rabe OC, Winther-Jensen M. et al. How common is the rare Charcot foot in patients with diabetes. Diabetes Care 2021; 44: e62-e63
    CrossrefPubMedSearch in Google Scholar
  • 3 Jansen RB, Jørgensen B, Holstein PE. et al. Mortality and complications after treatment of acute diabetic Charcot foot. J Diabetes Complications 2018; 32: 1141-1147
    CrossrefPubMedSearch in Google Scholar
  • 4 Jansen RB, Svendsen OL. A review of bone metabolism and developments in medical treatment of the diabetic Charcot foot. J Diabetes Complications 2018; 32: 708-712
    CrossrefPubMedSearch in Google Scholar
  • 5 Jansen RB, Christensen TM, Bülow J. et al. Bone mineral density and markers of bone turnover and inflammation in diabetes patients with or without a Charcot foot: An 8.5-year prospective case-control study. J Diabetes Complications 2018; 32: 164-170
    CrossrefPubMedSearch in Google Scholar
  • 6 Dardari D. Trends in the pathophysiology of Charcot neuroarthropathy. Trends Endocrinol Metab 2023; 34: 61-62
    CrossrefPubMedSearch in Google Scholar
  • 7 Poonoosamy J, Lopes P, Huret P. et al. Impact of intensive glycemic treatment on diabetes complications – a systematic review. Pharmaceutics 2023; 15: 1791
    CrossrefPubMedSearch in Google Scholar
  • 8 Dardari D, Ha Van G, M’Bemba J. et al. Rapid glycemic regulation in poorly controlled patients living with diabetes, a new associated factor in the pathophysiology of Charcot’s acute neuroarthropathy. PLoS One 2020; 15: e0233168
    CrossrefPubMedSearch in Google Scholar
  • 9 Dardari D, Schuldiner S, Julien CA. et al. Trends in the relation between hyperglycemia correction and active Charcot neuroarthropathy: Results from the EPICHAR study. BMJ Open Diab Res Care 2022; 10: e002380
    CrossrefPubMedSearch in Google Scholar
  • 10 Dardari D, Penfornis A, Hartemann A. The onset of acute Charcot neuroarthropathy during pregnancy in type 1 diabetes. Endocrinol Diabetes Metab Case Rep 2020; 2020: 20-0002
    PubMedSearch in Google Scholar
  • 11 Dardari D, Penfornis A, Amadou C. et al. Multifocal (tarsus and knee) activation of neuroarthropathy following rapid glycaemic correction. J Diabetes Complications 2019; 33: 107348
    CrossrefPubMedSearch in Google Scholar
  • 12 Huret P, Lopes P, Dardari R. et al. Rapid correction of Hyperglycemia: A necessity but at what price? A brief report of a patient living with type 1 diabetes. World J Diabetes 2023; 14: 1710-1716
    CrossrefPubMedSearch in Google Scholar
  • 13 Murchison R, Gooday C, Dhatariya K. The development of a Charcot foot after significant weight loss in people with diabetes: Three cautionary tales. J Am Podiatr Med Assoc 2014; 104: 522-555
    CrossrefPubMedSearch in Google Scholar
  • 14 Valabhji J. Immunosuppression therapy posttransplantation can be associated with a different clinical phenotype for diabetic Charcot foot neuroarthropathy. Diabetes Care 2011; 34: e135
    CrossrefPubMedSearch in Google Scholar
  • 15 Vecchio JJ, Raimondi N, Rivarola H. et al. Charcot neuroarthropathy in simultaneous kidney-pancreas transplantation: Report of two cases. Diabet Foot Ankle 2013; 4: 1-5
    CrossrefPubMedSearch in Google Scholar
  • 16 Matricali G, Bammens B, Kuypers D. et al. High rate of Charcot foot Attacks early after simultaneous pancreas-kidney transplantation. Transplantation 2007; 83: 245-246
    CrossrefPubMedSearch in Google Scholar
  • 17 Garcia Barrado F, Kuypers DR, Matricali GA. Charcot neuropathy after simultaneous pancreas-kidney transplantation: Risk factors, prevalence, and outcome. Clin Transplant 2015; 29: 712-719
    CrossrefPubMedSearch in Google Scholar
  • 18 Rangel ÉB, Sá JR, Gomes SA. et al. Charcot neuroarthropathy after simultaneous pancreas-kidney transplant. Transplantation 2012; 94: 642-645
    CrossrefPubMedSearch in Google Scholar
  • 19 Anthony ML, Cravey KS, Atway SA. Development of Charcot neuroarthropathy in diabetic patients who received kidney or kidney-pancreas transplants. J Foot Ankle Surgery 2019; 58: 475-479
    CrossrefPubMedSearch in Google Scholar
  • 20 Søe K, Delaissé JM. Glucocorticoids maintain human osteoclasts in the active mode of their resorption cycle. J Bone Miner Res 2010; 25: 2184-2192
    CrossrefPubMedSearch in Google Scholar
  • 21 Liu T, Wang Y, Quian B. et al. Potential metabolic pathways involved in osteoporosis and evaluation of fracture risk in individuals with diabetes. BioMed Res Int 2024; 2024: 6640796
    PubMedSearch in Google Scholar
  • 22 Saito M, Kida Y, Kato S. et al. Diabetes, collagen and bone quality. Curr Osteoporos Rep 2014; 12: 181-188
    CrossrefPubMedSearch in Google Scholar
  • 23 Das L, Bhansali A, Prakash M. et al. Effect of methylprednisolone or zoledronic acid on resolution of active Charcot neuroarthropathy in Diabetes: A randomized, double-blind, placebo-controlled study. Diabetes Care 2019; 42: e185-e186
    CrossrefPubMedSearch in Google Scholar
  • 24 Petrova NL, Dew TK, Musto RL. et al. Inflammatory and bone turnover markers in a cross-sectional and prospective study of acute Charcot osteoarthropathy. Diabet Med 2015; 32: 267-273
    CrossrefPubMedSearch in Google Scholar
  • 25 Xiang GD, Sun HL, Zhao LS. et al. Changes of osteoprotegerin before and after insulin therapy in type 1 diabetic patients. Zhonghua Yi Xue Za Zhi 2007; 87: 1234-1237
    PubMedSearch in Google Scholar
  • 26 Rasmussen LM, Tarnow L, Hansen TK. et al. Plasma osteoprotegerin levels are associated with glycemic status, systolic blood pressure, kidney function and cardiovascular morbidity in type 1 diabetic patients. Eur J Endocrinol 2006; 154: 75-81
    CrossrefPubMedSearch in Google Scholar
  • 27 Browner WS, Lui LY, Cummings SR. Associations of serum osteoprotegerin levels with diabetes, stroke, bone density, fractures, and mortality in elderly women. J Clin Endocrinol Metab 2001; 86: 631-637
    PubMedSearch in Google Scholar
  • 28 Avignon A, Sultan A, Piot C. et al. Osteoprotegerin is associated with silent coronary artery disease in high-risk but asymptomatic type 2 diabetic patients. Diabetes Care 2005; 28: 2176-2180
    CrossrefPubMedSearch in Google Scholar
  • 29 Anand DV, Lahiri A, Lim E. et al. The relationship between plasma osteoprotegerin levels and coronary artery calcification in uncomplicated type 2 diabetic subjects. J Am Coll Cardiol 2006; 47: 1850-1857
    CrossrefPubMedSearch in Google Scholar
  • 30 Zobel EH, von Scholten BJ, Lajer M. et al. High osteoprotegerin is associated with development of foot ulcer in type 1 diabetes. J Diabetes Complications 2016; 30: 1603-1608
    CrossrefPubMedSearch in Google Scholar
  • 31 Knudsen ST, Foss CH, Poulsen PL. et al. Increased plasma concentrations of osteoprotegerin in type 2 diabetic patients with microvascular complications. Eur J Endocrinol 2003; 149: 39-42
    CrossrefPubMedSearch in Google Scholar
  • 32 Marso SP, Daniels GH, Brown-Frandsen K. et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375: 311-322
    Search in Google Scholar
  • 33 Dhatariya K, Bain SC, Buse JB. et al. The impact of liraglutide on diabetes-related foot ulceration and associated complications in patients with type 2 diabetes at high risk for Cardiovascular events: Results from the LEADER trial. Diabetes Care 2018; 41: 2229-2235
    CrossrefPubMedSearch in Google Scholar
  • 34 Marso SP, Bain SC, Consoli A. et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375: 1834-1844
    Search in Google Scholar
  • 35 Rosenstock J, Wysham C, Frías JP. et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): A double-blind, randomised, phase 3 trial. Lancet 2021; 398: 143-155
    CrossrefPubMedSearch in Google Scholar
  • 36 Rosenstock J, Juan Frias J, Jastreboff AM. et al. Retatrutide, a GIP, GLP-1 and glucagon receptor agonist, for people with type 2 diabetes: A randomised, double-blind, placebo and active-controlled, parallel-group, phase 2 trial conducted in the USA. Lancet 2023; 402: 529-544
    CrossrefPubMedSearch in Google Scholar
  • 37 Goldney J, Sargeant JA, Davies MJ. Incretins and microvascular complications of diabetes: Neuropathy, nephropathy, retinopathy and microangiopathy. Diabetologia 2023; 66: 1832-1845
    CrossrefPubMedSearch in Google Scholar
  • 38 Kandeel M. The outcomes of sodium-glucose co-transporter 2 inhibitors (SGLT2I) on diabetes-associated neuropathy: A systemic review and meta-analysis. Front Pharmacol 2022; 13: 926717
    CrossrefPubMedSearch in Google Scholar
  • 39 Rosenstock J, Stephen C, Bain SC. et al. Weekly icodec versus daily glargine U100 in type 2 diabetes without previous insulin. N Engl J Med 2023; 389: 297-308
    CrossrefPubMedSearch in Google Scholar
  • 40 Gibbons CH. Treatment-induced neuropathy of diabetes. Curr Diab Rep. 2017 127.
    PubMedSearch in Google Scholar
  • 41 Bain SC, Klufas MA, Ho A. et al. Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review. Diabetes Obes Metab 2019; 2154-2466
    PubMedSearch in Google Scholar
  • 42 American Diabetes Association Professional Practice Committee. Retinopathy, neuropathy, and foot care: Standards for care in diabetes – 2024. Diabetes Care 2024; 47: S231-S243
    CrossrefPubMedSearch in Google Scholar