Once we get a cut or a scrape, our body´s immune system and wound healing mechanisms go into full swing, warding off germs to help prevent the wound from becoming infected. Blood clots, a scab forms over the injury, and it begins to heal in optimum fashion.
However, for people with diabetes, wounds tend to heal more slowly or do not heal well because the body cannot produce or use insulin. This hormone turns glucose or sugar into energy, but when your body struggles to metabolize it, sugar levels rise, affecting your wound healing ability.
A 2013 study in the Plastic and Reconstructive Surgery journal found a clear link between wound healing and blood glucose. The research revealed that people undergoing surgery for chronic diabetic wounds were more likely to heal fully if they were controlling their blood glucose levels at the time of surgery.
In general, diabetic wound healing follows the same process as normal wound healing but at a much slower rate.
Several crucial factors affect the healing of people with diabetes, including:
High blood sugars slow down wound healing at the cellular level by:
Diabetes can cause nerve damage (neuropathy) which is common in the hands and feet. Uncontrolled glucose levels damage nerves, numbing sensations. This can mean that people with diabetes who sustain a wound may not know they have an injury and so won´t receive treatment. Consequently, the wound will worsen. A combination of already slow healing and reduced sensation in an affected area increases the risk of infection.
People with diabetes are more likely to develop peripheral vascular disease (PAD), a condition of poor circulation. Blood vessels narrow, blood thickens from high blood sugars, and the blood can´t get to your extremities like it used to. All these complications affect the wound healing process.
The number of immune cells sent to wound sites is significantly reduced, affecting the body´s ability to fight off germs and increasing the risk of infection.
Among the other ways diabetes can affect wound healing include:
There are several things you can do to improve the wound healing process if you have diabetes.
Maintain a healthy diet: Good nutrition helps regulate glucose levels and gives your body the essential vitamins and nutrients to boost the healing process. Vitamin C, carbohydrates and adequate protein will help your defences. Speak to a dietician specializing in diabetes who will be able to advise you on the optimum diet.
Be aware of your body and do regular self-checks: Catching a wound early helps avoid infections that could turn into serious problems. Perform daily self-checks to look for new injuries and abnormalities, especially if you have diabetic neuropathy.
Keep pressure off wounds: Pressure slows the healing process because it impedes blood flow. Keeping the pressure off a wound on the bottom of your feet will get the blood flowing back into the affected area to facilitate healing.
Keep dressings fresh: Wound dressings help protect an injury from infections and changing them daily will help ensure they continue to do their job. They will also keep the wound moist. This is important because moist wounds heal faster than dry wounds. Moisture also provides a good environment for new cell growth.
Remove dead tissue from wounds: Dead cells in and around a wound encourage bacterial growth that worsens an infection. It can also be challenging to check the severity of a wound if there is too much dead tissue. Therefore, you may need a medical procedure known as debridement, which removes dead, damaged or infected tissue to improve a wound´s healing potential. Debridement is only necessary when an injury isn´t healing well on its own.
Give up smoking: Kicking the habit will help in many areas of your life, including improving your circulation and overall health.
Here at the Midwest Institute for Non-Surgical Treatment (MINT), we provide specialist treatments for conditions that affect wound healing, such as PAD.
Book an appointment with Dr. Akinwande and the team who can treat you at one of our convenient locations in the St Louis area. We can also advise you on how best to prevent and care for diabetic wounds.