Meet the Researcher: Dr Nina Petrova – by Kotryna Temcinaite
We recently got the opportunity to chat to two of our fantastic researchers (Dr David Long and Dr Nina Petrova) on camera, and you can check out the video below.
As promised in the previous blog post about David’s research, I now share Nina’s research story. Nina is a clinical research scientist and works in the Diabetic Foot Clinic at King’s College Hospital London. She’s interested in the Charcot foot – a serious complication of diabetes.
The legacy of a French doctor
Nina explains: “Charcot foot is a bone and joint complication in diabetes, and it bears the name of the French doctor who first described the condition. It affects people with diabetes who have lost sensation due to nerve damage, and is usually set off by simple trauma – like tripping on the kerb or running after a bus. The trauma often may remain unnoticed, but can lead to fractures.
These fractures take very long time to heal and may lead to collapse of the foot and deformity. People with the Charcot foot may develop a foot ulcer, which can become infected, require long hospital admissions and sometimes may even require an amputation.
Charcot foot can affect people with both Type 1 and Type 2 diabetes, and it affects people at every age – one of our youngest patients is 21 years old.”
Not a rare condition anymore
“It is very important to be actively looking for the Charcot foot. In the past it has been considered as a rare complication, but at that time we didn’t have sensitive enough methods to diagnose it. Only in recent years we’ve learnt to recognise it early using new imaging methods.
Once we have established criteria and awareness of this condition, I’m sure that we will find more people affected by it and it won’t be considered as a rare complication.”
Plaster cast – the only therapy
“Unfortunately, at present we don’t have an established medical therapy for this condition. The only treatment available is prolonged immobilisation of the foot in a plaster cast. Casting therapy can last on average 10 months, but can be as long as 20 months.
Such therapy is followed by gradual rehabilitation from a cast to bespoke footwear. If you have Charcot foot, it’s very important to wear special footwear, as it takes into account the deformity and may prevent foot ulcers from developing.
We urgently need more treatment options for Charcot fractures.”
Bioceramics for treating Charcot foot
“I’m planning to work on a very exciting project. Recently, a group of substances called bioceramics have been successfully used to treat ‘difficult to heal’ fractures; these substances can be applied directly at the fracture sites. With our Diabetes UK funded project, we plan to find out whether new bioceramics can be used to treat Charcot fractures.
The underlying reason for the non-healing fractures in people with Charcot foot is reduced activity of bone-making cells (called osteoblasts) and increased activity of bone-breaking cells (called osteoclasts). We want to find out whether these new bioceramic materials can improve the activity of bone-making cells and counteract the activity of the bone-breaking cells. So first we need to find out how these two different types of cells, taken from blood samples of people with Charcot foot, interact with bioceramic materials in the laboratory.
These experiments are very important, because we would like to use bioceramic materials as a scaffold or a framework to heal fractures. It may be a new way to go forward to treat Charcot fractures. Overall, we hope that this project leads to a new treatment for Charcot foot.
Using bioceramics to treat fractures in people with Charcot foot will have a huge impact, because this may lead to faster and complete healing of fractures. Of course, this may also lead to a significant reduction in foot deformity, which in turn means less ulcers and hopefully less amputations.”
The way to go forward
“We are very grateful to every person who supports Diabetes UK, because this is how we can go forward. We can provide better treatments by doing research studies. And we all need to work together: people with diabetes, clinicians, scientists, and of course Diabetes UK, to find better ways to prevent and manage diabetes.”
Nina is an inspiring scientist and it was a great pleasure talking to her. If you would like to read more about Nina’s project or adopt it, you can find it on our website.
This blog post was written by Kotryna Temcinaite, Research Communications Officer at Diabetes UK.
Read more of our research blogs.