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Diabetes and Wound Healing: Why Is It Slower, and How Can We Promote The Healing?

In diabetes, wound healing may be several times slower than in healthy adults. The rate of recovery would highly depend on the severity of diabetes. Diabetes is not just about high blood glucose; it is a much broader metabolic disorder. Thus, those living with diabetes have hyperlipidemia, altered protein metabolism, and disturbed micronutrient profile.

In diabetes, the metabolism of almost every nutrient is altered. Therefore, blood glucose is merely the most dependable indicator of the severity of diabetes.

In diabetes, slow wound healing occurs because:

  • Poor vascular health: One of the major complications of diabetes is changes in large and small blood vessels. It means that many parts of the body have compromised blood supply. It means local hypoxia (low oxygen) and poor nutrients. 1
  • Altered local immune responses: It means that the body is unable to defend wounds from infections adequately. Moreover, immune cells are also responsible for healing processes. Thus, healing processes are highly compromised.
  • Poor nerve signaling: High blood glucose is especially bad for peripheral nerves. It may not essentially cause pain, but it may disrupt local communication. Since the communication is altered, the body is not able to respond adequately to wounds.
  • Greater risk of wound infection: Unlike other causes, this is both due to intrinsic and extrinsic reasons. Almost any wound will get exposed to pathogens and opportunistic infection. But, in healthy adults, local immunity will overcome these pathogens. However, in diabetes, infections may readily flourish, and even worst, they may form a fine line of defense called biofilm.
  • Stress: In diabetes, greater emotional stress also slows down healing, yet it remains an overlooked factor. 2

Promoting Wound Healing in Diabetes

  • Adequate blood sugar control: Controlling blood sugar also improves insulin sensitivity, and boosts various metabolic processes, resulting in much better healing.
  • Exercise: It is one of the ways of promoting peripheral blood flow, improving the functioning of peripheral nerves. It also helps boost other body functions and gain better control over diabetes.
  • Manage stress: Stress hormones slow down immune responses and may slow down wound healing
  • Focus on micronutrients: Some of the micronutrients like vitamins and minerals work like catalysts. They do not provide energy or form body structures, but they may considerably boost various chemical processes in the body.
  • Increase in antioxidants intake: In recent years, antioxidants have gained tremendous attention. These are the products that help counter free radicals, thus reducing inflammation-related damage to the tissues and boosting healing processes.
  • Consider natural anti–inflammatory foods: Some foods may boost metabolism, lower blood sugar levels, and lower inflammation like curcumin, cinnamon, berries, and nuts.
  • Break bacterial defenses: It means the application of creams and ointments to break biofilm, and kill pathogens. There are many herbals known to have such properties apart from creams containing antiseptics. Generally, for minor issues, natural therapies are better as they also boost healing processes. 3

These are some of the natural ways of wound healing. Since diabetes is a chronic disorder, taking more medications for wound healing may not always be an option. The best way to manage diabetes is to combine lifestyle interventions, traditional therapies with drug therapy.

References

  1. Baltzis D, Eleftheriadou I, Veves A. Pathogenesis and Treatment of Impaired Wound Healing in Diabetes Mellitus: New Insights. Adv Ther. 2014;31(8):817-836. doi:10.1007/s12325-014-0140-x
  2. Razjouyan J, Grewal GS, Talal TK, Armstrong DG, Mills JL, Najafi B. Does Physiological Stress Slow Down Wound Healing in Patients With Diabetes? J Diabetes Sci Technol. 2017;11(4):685-692. doi:10.1177/1932296817705397
  3. Laitiff AA, Teoh SL, Das S. Wound healing in diabetes mellitus: traditional treatment modalities. Clin Ter. 2010;161(4):359-364.