White Paper: Allostasis: A Conceptual Framework to Better Understand and Prevent Diabetic Foot Ulcers

Laurel Tanner, M.A. Lead Writer, EC-Service, Centerville, UT

Dr. Craig Oberg, PhD. Professor of Microbiology, Weber State University, Ogden UT

Evan Call, MS, CSM (NRM). Adjunct Professor of Microbiology, Weber State University, UT

Consulting: Dr. Darren Groberg, DPM & Susan Jellum, MSN, RN

ABSTRACT

BACKGROUND: Diabetic foot ulcers (DFU) are an ongoing problem in the healthcare field, in spite of many people working to treat and to prevent them. Current understanding, based in part on the homeostasis model, is insufficient to change the ongoing incidence rate.

PURPOSE: This paper introduces the concept of allostasis, an approach which expands on the familiar concept of homeostasis and which allows for better patient treatment and interventions through understanding that the body adapts to fluctuating needs through reallocating resources which are interactive but finite. Allostasis assumes that variance itself is normal and seeks to support this adaptability.

METHOD: A review of literature informs discussion of two primary etiologies for tissue injury and provides context for the physiological response to forces present which leads to tissue damage and DFU.

IMPLICATIONS: While it is well recognized that the body adjusts to varying input, this idea has not been incorporated into treatment paradigms or methodologies.

CONCLUSION: The allostasis approach will aid in preventing DFU by allowing more detailed understanding of the disease, integration of targeted clinical practices and will allow better intervention tools