Diabetes-impaired wound healing predicted by urinary nitrate assay: A preliminary, retrospective study

Diabetic wound healing is occasionally impaired and associated with chronic foot ulceration and lower extremity amputation (LEA). Topically applied pl atelet-derived growth factor (rhPDGF-BB) increases healing in less than 50 percent of these cases suggesting that other factors are involved. Ln a pre liminary, retrospective study of diabetic ulcer patients receiving rhPDGF-B B (becaplermin*), we show that urinary concentrations of the nitric oxide ( NO) metabolite nitrate are significantly (p<0.05) reduced in patients with poor or absent ulcer healing as compared to patients with healed ulcers or non-diabetic controls. This suggests that significantly decreased endogenou s NO production predicts diabetic wound outcomes in patients treated with b ecaplermin. These preliminary findings also appear to support further inves tigations of the clinical use of urinary nitrate levels as a tool to guide therapy during treatment of diabetic ulcers.