![]() The two different emulsion types (W/O and O/W) exhibit different properties and thus differ with respect to influencing the pH SS. ![]() In contrast to previous studies investigating a pH 4 O/W emulsion, the effect on pH SS of a pH 4 W/O emulsion was investigated regarding the acidifying properties. Topical application of pH 4 W/O emulsion for 2 weeks led to a significant reduction in pH SS on the bottom and the dorsum of the foot, as well as interdigitally (fig. Overall, intertriginous regions exhibited slightly higher pH SS values. Even though not significant, pH SS was slightly higher at all localizations in diabetics than in control patients (fig. In diabetic patients, however, we found significantly lower pH SS values on the lower leg compared to the axillary and inguinal regions. For the other localizations (axillary and inguinal regions and the lower leg), there were no significant differences in pH SS between diabetics and controls (fig. A similar tendency was seen on the right foot but the results were not significant (fig. However, interdigital pH SS of the left foot was significantly higher compared to pH SS on the dorsum (fig. Additionally, no significant differences were detected between the left and right foot - both for diabetics and controls. There were no significant differences in pH SS between diabetics and controls on the bottom and the dorsum of the foot, as well as in the interdigital region (fig. Clinical Trial to Assess Long-Term Efficacy and Tolerability However, due to the limited sample size, there was only a trend towards bacterial reduction following application of the emulsion (data not shown). ![]() Bacterial colonization was assessed by swabs before and after application of the emulsion. HbA 1c of diabetics amounted to 7.8 ± 0.4% and blood sugar levels were 164 ± 18.1 and 131.4 ± 12.7 mg/dl, respectively (data not shown). Diabetes was diagnosed 12.3 ± 2.9 years prior to measurements. All diabetic volunteers suffered from insulin-dependent diabetes mellitus. The respective untreated foot of the other side served as control. In addition, diabetic volunteers applied a pH 4 W/O emulsion to one foot of each patient (randomized) twice daily for 2 weeks and pH SS was measured thereafter. Male volunteers (diabetics: n = 10, 70.2 ± 2.6 years nondiabetics: n = 10, 59.8 ± 3.5 years) were included for measurement of pH SS of the axillary, inguinal, interdigital and plantar region, as well as of the lower leg and the dorsum of the foot.
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