Given the abnormalities of the microvasculature and other side effects of diabetes, these wounds take a long time to heal and require a specialized treatment approach for proper healing. As many as 75% of diabetic patients will eventually develop foot ulcers, and recurrence within five years is 70%. If not aggressively treated, these wounds can lead to amputations. It is estimated that every 30 seconds a lower limb is amputated somewhere in the world because of a diabetic wound. Amputation often triggers a downward spiral of declining quality of life, frequently leading to disability and death. In fact, only about one third of diabetic amputees will live more than five years, a survival rate equivalent to that of many cancers. Many of these lower extremity amputations can be prevented through an interdisciplinary approach to treatment involving a variety of advanced therapies and techniques, such as debridement, hyperbaric oxygen treatment therapy, dressing selection, special shoes, and patient education. When wounds persist, a specialized approach is required for healing. Pathophysiology
To heal a wound, the body undertakes a series of actions collectively known as the wound healing process. Diagnosis
A wound may be recorded for follow-up and observing progress of healing with different techniques which include:
Photographs, with subsequent area quantification using computer processing
Wound tracings on acetate sheets
Kundin wound gauge

Management
The overall treatment depends on the type, cause, and depth of the wound, and whether other structures beyond the skin (dermis) are involved. Treatment of recent lacerations involves examining, cleaning, and closing the wound.
Mutations that alter only the C-terminal of the protein also result in a mild phenotype of the disorder, usually sparing the brain. ML IV causes affected cells to accumulate auto-fluorescent vacuoles considered to be aberrant lysosomes. Several evidences exist for a defect in both exocytosis and endocytosis. There are conflicting indications of abnormal lysosomal pH in MLIV. It is not yet clear why these abnormalities will cause incomplete development of the brain, achlorhydria, and failure in the maintenance of retinal tissue. Diagnosis
Diagnosis includes genetic testing and Gastrin blood test to check for low iron in the blood. Treatment
There is no specific treatment to this disorder. However, several symptoms may be alleviated. For instance, anemia is treated by iron supplements. Some of the movement deficiencies may be corrected with orthopedic intervention. The corneal clouding can be, at least, temporarily corrected by corneal transplantation. See the equivalent section in the main mucolipidosis article. Epidemiology
Mucolipidosis type IV is severely under-diagnosed. It is often misdiagnosed as cerebral palsy. In the  Ashkenazi Jewish population there are two severe mutations with a higher carrier frequency of 1:90 to 1:100. References
External links

Mucolipidosis type 4 at NIHs Office of Rare Diseases