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HEBERPROT-P: a unique therapy to avoid diabetes-related amputations

a variety of diabetes management programmes available in Cuba for foreign patientsDiabetes can be managed effectively and controlled once it has been accurately diagnosed. The goal of diabetes management is to prevent short-and long-term complications of diabetes from developing.

Without proper management, people with diabetes can develop serious or deadly complications from high glucose levels, including blindness, kidney disease and nerve damage, as well as vascular disease that can lead to amputations, heart disease, and strokes. Uncontrolled diabetes can complicate pregnancy; birth defects are also more common in babies born to women with uncontrolled diabetes. Treating diabetes in a comprehensive manner includes not only managing blood glucose but also blood pressure and cholesterol. This is crucial in helping to prevent heart attacks and stroke.

There is good news; people with diabetes who maintain lower blood glucose, blood pressure and cholesterol levels can lower their risk of cardiovascular disease. Diabetes treatment guidelines emphasize the importance of aggressive blood pressure control in lowering the risk for heart disease, stroke, and early death in people with diabetes. Before most of the focus in diabetes care had been on tightly controlling blood sugar, but new evidence suggests that both blood sugar and blood pressure are very important in managing the disease.

Without proper management, people with diabetes can develop serious or deadly complications from high glucose levels, including blindness, kidney disease and nerve damage, as well as vascular disease that can lead to amputations, heart disease, and strokes. Uncontrolled diabetes can complicate pregnancy; birth defects are also more common in babies born to women with uncontrolled diabetes. Treating diabetes in a comprehensive manner includes not only managing blood glucose but also blood pressure and cholesterol. This is crucial in helping to prevent heart attacks and stroke. There is good news; people with diabetes who maintain lower blood glucose, blood pressure and cholesterol levels can lower their risk of cardiovascular disease. Diabetes treatment guidelines emphasize the importance of aggressive blood pressure control in lowering the risk for heart disease, stroke, and early death in people with diabetes. Before most of the focus in diabetes care had been on tightly controlling blood sugar, but new evidence suggests that both blood sugar and blood pressure are very important in managing the disease.
How To Seek Treatment
If you are diagnosed with diabetes, it's important that you receive comprehensive informationwhether from a primary health care professional, a certified diabetes educator, or an endocrinologist.

Charcot Foot Treatment in Cuba

Charcot foot can occur in a diabetic who has neuropathy (nerve damage) in the foot that impairs the ability to feel pain. Charot foot typically occurs following a minor injury, such as a sprain or stress fracture. Because the patient doesn't feel the injury, he or she continues to walk, making the injury worse. Bones fracture, joints collapse and the foot becomes deformed. The patient walks on the side of the foot and develops pressure sores. Bones can become infected.

Both traditional surgical techniques, in which bones are held in place by internal plates and screws, (however it doesn't work with a subset of obese Charcot patients) and external fixators (see Orthopedic costs and prices in Cuba for more) are among Cuban treatment options.

Diabetic foot ulcer is a principal diabetic complication. Unfortunately, 84% of lower-limb amputations are an effect of so-called diabetic foot, chronic foot ulcers suffered by 15 to 20 percent of diabetes patients at some point in their lives. Ten to 25 percent of these patients will end up having some kind of amputation. It could be said that every 30 seconds, a diabetes patient of either sex is being amputated in a health center somewhere in the world. About 50 percent of these patients undergo a second amputation on their other lower limb. After a major amputation, fewer than 50 percent of amputees survive for more than five years.

After a foot ulcer has formed, it will not heal as long as weight-bearing on the area continues. Unless your foot ulcer is infected, your doctor may put a cast on your leg to help the ulcer heal. Keeping your weight off your injured foot is very important. Even when you are at home, be careful to stay off that foot. Cushioned shoes, orthotic inserts, support with a cane or crutches, and - in extreme cases - a wheelchair and bed rest may be used to reduce weight and pressure on the feet. Foot infections need to be treated with antibiotics.
It has been shown that diabetic patients have decreased growth factor concentrations in their tissues, particularly epidermal growth factor. Growth factor shortage impairs wound healing, which leads to chronic nonhealing wounds and sometimes eventual amputation. Ischemic diabetic foot ulcer is the most difficult to treat and confers the highest amputation risk. Injecting epidermal growth factor deep into the wound bottom and contours encourages a more effective pharmacodynamic response in terms of granulation tissue growth and wound closure. Epidermal growth factor injected into the ulcer matrix may also result in association with extracellular matrix proteins, thus enhancing cell proliferation and migration.

HEBERPROT-P is a drug for stimulating and sustaining scar formation for chronic ulcers of all types on the lower extremities of diabetic patients

It's a new injectable medicine developed by eminent Cuban scientists at the national Genetic Engineering and Biotechnology Center (CIGB), together with highly qualified professionals of the National Institute of Angiology and Vascular Surgery. Heberprot-P is an innovative Cuban product containing recombinant human epidermal growth factor for peri- and intra-lesional infiltration. Its therapeutic properties, method of application and niche indications are unique internationally. Evidence reveals it accelerates healing of deep and complex ulcers, both ischemic and neuropathic, and reduces diabetes-related amputations. Without any kind of disfiguring surgery, its application through intralesional injection into the diabetic foot ulcers accelerates their scar formation, even for deep and complex ones, also reducing the number and spread of extirpation and debridement of dead or necrotic tissue. In preventing recidivism, there is an evident reduction of time for scar formation, and other complications are avoided, such as gangrene and infections. Clinical trials of Heberprot-P in patients with diabetic foot ulcers have shown that repeated local infiltration of this product can enhance curing of chronic wounds safely and efficaciously. As a result, Heberprot-P was registered in Cuba in 2006, and in 2007 was included in the National Basic Medications List and approved for marketing. It has been registered in 15 other countries, enabling treatment of more than 100,000 patients.

Cuban Diabetes Control Programs

Cuba possesses strong experience in attention of diabetic people with emphasis in childhood endocrinology illnesses, obesity and Metabolic Syndrome; Disorders in Sexual Development; Reproductive Risk Factors in Diabetes and Infertility in men and women with diabetes.



Model Diabetes Mellitus Treatment Program in Cuba

The Diabetes Mellitus is one of the most frequent illnesses in the world. It is of chronic character and its inadequate handling drives to serious affectations of organs and systems that are vital to support a useful and productive life. Once controlled and with your help it will allow you to realize your daily activities and to avoid risks that could lead you to other chronic not transmissible illnesses that could bring about serious avoidable complications.

The expenses corresponding to the companion are not included in this program, the person will pay $40.00 CUC daily and it will include: accommodation and food.

This program does not include the transfer.

PRICE: $4256.00 CUC.

heberprot-p - for today the only existing alternative to amputationHeberprot-P is a unique therapy for the most complicated and recalcitrant chronic wounds usually associated with high amputation risk. Local injection in complex diabetic wounds has demonstrated a favorable risk-benefit ratio by speeding healing, reducing recurrences and attenuating amputation risk. Further testing and deployment worldwide of Heberprot-P would provide an opportunity to assess the product's potential to address an important unmet medical need.