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How Diabetes Affect Wound Healing?

Diabetes is a metabolic disorder in which body fails to utilize sugar resulting in higher blood glucose levels. It has potential of complicating many aspects of human health such as vision, digestion, vitality, fertility and wound healing.


With the current population at over 100 million, the Philippines has more than 5 million diagnosed with diabetes. The foundation noted that some 50,000 diabetic Filipinos died in 2017 due to diabetes-related complications like heart attack, stroke, and kidney and heart failure.

Small cuts, bruises, scratches, and abrasions are part of routine life and it’s really hard to avoid them at all. These small injuries are completely safe and easy to heal in general healthy population. However, such is not the case with diabetics. It can be easily observed that developing any kind of wound is a nightmare for diabetic people as they the fact that it won’t vanish easily. In diabetes, these ordinary cuts can transform into infected wounds that won’t heal easily. Hence, they should never be ignored and should be taken good care of to avoid any complicated wound. Catching and curing a wound at an early stage is the key to proper healing.


So what is the reason behind the slow healing of diabetic wounds? How does diabetes control this wound healing process? In order to be specific, it’s not diabetes but the uncontrolled sugar levels that play havoc with body. If a person has good control over it, he/she won’t have to face any kind issues with healing process. It is important to understand the mechanism behind this phenomenon to better educate the people with diabetes and prevent any grave consequences such as amputation of the wounded part.


1. Disturbed immunity:

White blood cells are the first line of immunity and prevent the body from infection and pave the road to healing process. When any kind of injury happens, white cells get mobilized to that wounded area and start the recovery process. They inhibit any possible infection and help in the formation of new healthy tissue. Studied have confirmed that consistently higher levels of glucose have a bad impact on WBCs and disrupt their normal functioning. They fail to mobilize towards the wound site and can’t activate their enzymes in presence of higher sugar levels. If a diabetic person has good control over blood glucose, he won’t face this issue of delayed healing.


2. Poor circulation:

Diabetic wounds are most commonly present on peripheries such as feet and legs as a peripheral body has compromised blood supply in diabetes. Healthy blood circulation is inevitable for good wound healing as it contains all the nutrients and substances that will flush out the debris and make a foundation for new body tissue. In diabetes, arteries become stiffened, hard and narrow resulting in poor blood circulation. When wound is not getting enough nutrients and WBCs from blood, it will keep on failing to heal.


3. Diabetic neuropathy and loss of sensation:

Excessively higher levels of glucose for a longer period of time interfere with body sensations and cause disruption in nerves’ functioning. This loss of sensation is the reason why diabetics have ulcers and wounds on their feet. Hands and feet are mainly affected by this malfunctioning of nerves and patient can easily get a wound as he/she has no sensation of pain. Self-checks are crucial to get to know about any possible injury to feet. Walking bear footed should be avoided and good quality stockings and shoes can protect against foot ulcers.


4. Higher probability of infections:

Our immune system loses its efficiency in uncontrolled diabetes as circulating glucose causes down regulation of white blood cells and immune-mediated chemicals. The body loses its natural shield to some extent and becomes susceptible to a number of infections. In addition, the presence of extra sugar provides nourishment to bacteria further aggravating infection. Non-resolution of infection can spread to adjacent tissues and may lead to sepsis and gangrene increasing chances of tissue death and amputation. Diabetes is the single leading causing of amputations worldwide.


5. Miscellaneous factors:

When diabetes remains uncontrolled for longer periods of time, it affects each and every tissue of body rendering them weak and easy to be diseased. A weakened skin barrier, decreased production of healing hormones, less collagen synthesis and reduced production of new blood vessels are some other important factors that may halt wound healing.


References:

https://journals.lww.com/plasreconsurg/pages/articleviewer.aspx?year=2013&issue=10000&article=00049&type=abstract

https://www.ncbi.nlm.nih.gov/pubmed/2179891

https://www.woundcarecenters.org/article/living-with-wounds/how-diabetes-affects-wound-healing




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