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How Diabetes Affects Wound Healing

Diabetes And Its Effects On Wound Healing

Diabetes And Its Effects On Wound Healing

Abstract This article discusses the reasons why wounds in people with diabetes take longer to heal and are more susceptible to complications. The physiology of the wound healing process, and how this is affected by diabetes, is outlined. The article also explains why wounds in patients with diabetes are more prone to infection and discusses preventive measures. Discover the world's research 14+ million members 100+ million publications 700k+ research projects Join for free Download Continue reading >>

Compromised Wound Healing In Ischemic Type 2 Diabetic Rats

Compromised Wound Healing In Ischemic Type 2 Diabetic Rats

Abstract Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8weeks high fat diet (HFD) feeding regimen followed by multiple injections of streptozotocin (STZ) at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds. Figures Citation: Yang P, Pei Q, Yu T, Chan Continue reading >>

Diabetic Wound Healing Through Nutrition And Glycemic Control

Diabetic Wound Healing Through Nutrition And Glycemic Control

Diabetes has quickly become one of the most complex health challenges of the 21st century. In 2010, a total of 10.9 million US residents ages 65 years and older were reported to be living with diabetes.1 Currently, it is the seventh-leading cause of death in the US, totaling 4.6 million deaths in 2011 (with healthcare expenditures reaching more than $471 billion.)2 A condition that increases one’s risk for heart disease and stroke, diabetes is also the leading cause of kidney failure, new cases of blindness among adults, and non-traumatic lower-limb amputations. Approximately 15% of individuals who live with diabetes develop a foot ulcer, and 84% of this population will end up with lower-leg amputations.3 Several factors can disrupt wound healing. Without proper nutrition, a normal wound can rapidly become a chronic, infected wound. However, it is possible for wound care providers to reduce the huge economic burden and life-threatening complications of diabetes by implementing timely, easy-to-use interventions. Comprehensive diet and nutrition management have been shown to promote optimal glycemic control and facilitate wound prevention and healing. As such, all healthcare professionals should know how to adequately manage blood glucose levels to support wound healing in patients living with diabetes. This article explains how uncontrolled blood sugar impairs wound healing and offers practical nutrition recommendations and guidelines that promote healing, as well as simple suggestions to prevent further complications and comorbidities. Effect of Diabetes Diabetes often causes slow-healing wounds that can worsen rapidly — with elevated blood glucose levels serving as the initial barrier to healing. Thus, achieving optimal glycemic control is imperative. Hyperglycemia Continue reading >>

Diabetes And Wound Healing

Diabetes And Wound Healing

According to the 2017 National Diabetes Statistics Report, it is estimated that 30.3 million Americans have diabetes, a medical condition in which the body cannot effectively process sugar. Individuals with diabetes lack the ability to convert sugar to fuel efficiently, causing elevated blood sugar levels. Only 23.1 million of these individuals have been diagnosed, while an alarming 7.2 million are are not aware that they have diabetes.1 Complications due to diabetes can affect almost every biological process performed and many organs including the eyes, kidneys, nerves, and feet. Diabetes can also cause heart disease, stroke and even the need to remove a limb due to chronic wounds and poor circulation. This article will focus on how diabetes affects wound healing. Diabetes can slow, halt, or even reverse the body’s natural wound healing process. Proper wound care in individuals with diabetes is critical to recovery and often needs close monitoring by a health care provider. Even stable wounds can suddenly and quickly worsen in those with diabetes. Why does this happen? Blood Sugar Levels & Circulation Elevated blood glucose levels over a long period of time can lead to narrowing of blood vessels and stiffening of the arteries, a type of blood vessel that carries blood to the rest of the body. This can cause wounds to form and prevent biological healing processes. High blood sugar activates a biological protein called protein kinase C, which causes constriction of blood vessels. When blood vessels become narrowed, the decrease in blood flow may cause a wound to form or perpetuate an existing wound. Blood cells also carry nutrients to tissues that are necessary to recover and fight infection. Reduced blood flow to the wound and subsequent decrease in oxygen supply can Continue reading >>

Wound Healing In The Patient With Diabetes Mellitus.

Wound Healing In The Patient With Diabetes Mellitus.

Abstract Reports of an increased incidence of wound complications in surgical patients with diabetes mellitus may actually reflect the increased incidence of general surgical risks or metabolic abnormalities associated with diabetes mellitus. Factors such as age, obesity, malnutrition, and macrovascular and microvascular disease may contribute to wound infection and delayed wound healing especially in the type II diabetic patient. In addition, hyperglycemia caused by decreased insulin availability and increased resistance to insulin can affect the cellular response to tissue injury. Studies of the immune cells necessary for wound healing, such as PMN leukocytes and fibroblasts, as well as studies of injured tissue suggest that there is a delayed response to injury and impaired functioning of immune cells in diabetes mellitus. There is evidence that these impairments may be the result of both an inherent (genetic) defect as well as decreased insulin availability and increased blood glucose concentration. At the time of hospital admission, little can be done to affect most of the risk factors or inherent cellular defects. However, blood glucose levels can be controlled with the use of bedside blood glucose monitoring and frequent adjustment of insulin dosing. Nurses have traditionally played an important role in monitoring recovery from surgery and watching for signs of infection and wound complications. These nursing functions are especially important in the diabetic patient. In addition, frequent evaluation of the effectiveness of insulin therapy is an important nursing function throughout the perioperative period. Through improving management of blood glucose levels in surgical patients, nurses can have a major impact on the incidence of wound complications in diabetes Continue reading >>

How Diabetes Affects Wound Healing

How Diabetes Affects Wound Healing

Caring for a loved one living with diabetes is quite a responsibility and when it comes to the approximately 29.1 million people living with diabetes in the U.S., it’s important to know the types of complications your loved one may face as a result of the disease. What many people may not know is that diabetes can result in diabetic foot ulcers. Healogics, Inc. encourages those living with diabetes and their caregivers to know how to take good care of their feet. Healogics is a wound care services management company, putting patient care at the forefront of everything we do. With nearly 800 Wound Care Centers® across the nation that are part of the connected network of outpatient centers, academic medical centers and other post-acute sites, we offer an evidence-based systematic approach to advanced wound care treating an underserved and growing patient population. Twenty-five percent of people living with diabetes will eventually develop a foot ulcer due to diabetic complications and foot ulcers precede 85 percent of lower extremity amputations in patients with diabetes. This disease can also cause heart disease, stroke, lack of circulation and feeling in the lower limbs and other complications which can result in hard-to-heal wounds. The fear of losing a limb is very real for people living with diabetic foot ulcers. Healogics offers hope to these individuals with longstanding (chronic) wounds through data, advanced wound care therapies like hyperbaric oxygen treatment, and access to wound care specialists who are passionate about finding a solution that will work for each individual patient. Healogics mission is to share our wound care expertise with every patient who could benefit, wherever they are, and by the best means available. With nearly half of our patients Continue reading >>

How Does Diabetes Affect The Feet Specifically?

How Does Diabetes Affect The Feet Specifically?

Long standing uncontrolled diabetes causes glycosylation of proteins throughout body,causing damage to blood vessels and nerves. Usually, manifestations occur after 10-12 years. Specifically, in relation to feet- It causes blood vessel damage- vasculopathy which impairs blood supply to nerves,damaging them which causes gradual loss of position sense,joint sense and pain sensation, So,patients are not able to sense trauma, which causes ulcers that go unnoticed, which is further infected by bacteria because of poor wound healing (decreased blood supply, weak immune system due to high blood levels and highly rich media for bacterial growth coz of high blood glucose). Coz,patients don't feel any pain,unless they regularly examine their feet,they can develop really big infected wounds causing death of tissue ( gangrene) and/or extension of infection in deeper tissues ( cellulitis,necrotising fascitis),bone(osteomyelitis) When limb or toes are dead and not salvageable, or there is threat to viability of proximal leg,or its causing threat to life of a patient, amputation is required along with extensive blood glucose control. Apart from this,many a times diabetic neuropathy can be very painful( cry of dying nerves),however as damage progresses,pain diminishes over few months to few years. Diabetes also causes Charcot foot,which occurs because of loss of joint and position sense(due to damaged nerves) resulting into bony deformity and altered shape of feet,making these patients further prone to falls and injuries Diabetic foot usually indicates long standing poor blood glucose control and most changes are irreversible, however extensive blood glucose control can prevent further damage and complications. Also read( for more information on diabetes) Continue reading >>

How Does Diabetes Affect Wound Healing

How Does Diabetes Affect Wound Healing

Abnormal amounts of blood glucose brought about by diabetes can, after some time, influence the nerves (neuropathy) and lead to poor blood distribution, making it hard for blood to clot and repair the skin of the wounded area. Thus, the wounded part of the skin stays open and unhealed for a considerable length of time. This increases the chances of conditions like parasitic contaminations, bacterial contaminations and gangrene in various parts of the body, especially the feet. Why does this Happen in Diabetic Patients? In Diabetic patients, the blood glucose levels are high and that can decrease the chances of mending wounds for longer periods of time. Moderate repairing wounds are clinical observations that are said to be the side effect of undiscovered diabetes, and this can be particularly dangerous because if you get a bruise or a cut somewhere, you keep on bleeding. In most severe cases, this might result into amputation of your body part. et’s look into some of the affects of harboring diabetes. Poor Circulation Narrowed veins lead to diminished blood stream and oxygen to any injury acquired on your body part. The farther the body part from your heart, the longer it takes for your narrowed artilleries and capillaries to carry oxygenated blood to them. An increased glucose level reduces the capacity of red platelets that convey nutrients to the tissue. This brings down the productivity of the white platelets that battle contamination. Without adequate nutrients and oxygen, an injury heals slowly. Glucose Levels in Blood Circulation A heightened glucose level hardens the supply routes and causes narrowing of the veins. The amount of blood clotting enzymes in the blood decreases and thus affects the healing of the wounds. Deficiency of Immune System Diabetes brings Continue reading >>

What Is To Be Done For Diabetes Foot Problem?

What Is To Be Done For Diabetes Foot Problem?

"Diabetes foot problem" - there are quite a lot of problems diabetes causes in the feet. This answer is not medical advice and implies no doctor-patient relationship. This is the internet and I will speak in generalities about how diabetes affects the feet and why controlling diabetes is vital to keeping your feet - yes, I did say keeping them, because diabetes is the number one cause of amputations in the developed world. 1. Diabetic neuropathy. Many people begin to lose sensation in their feet, which gradually extends up their legs. This is usually accompanied by severe pain. This is because the nerves in your legs are slowly suffocating under the toxic load of sugar that is gradually preventing them from getting the oxygen they need from your arteries. It's like slowly tightening a noose around your leg until it starts to hurt. 2. Diabetic foot ulcers/infections. As the blood flow to your legs decreases as sugar and cholesterol build up in your arteries, there will be poor wound healing and reduced skin strength. Because many diabetics lose feeling in their feet, they may get blisters or burns and not notice them. Because their healing is impaired, these wounds can rapidly get out of control. More than a few people show up in any given hospital in America in any given week and have to have their foot taken off because of a wound that wasn't taken care of promptly. The solution? Eat lots of green vegetables, fresh vegetables, and cut out sugar and refined carbs like flour, rice, or soda. Otherwise, you're more than likely to lose your feet. Literally. Again, this isn't medical advice - I can't offer an opinion on what to do about your "problem" because I can't practice medicine over the internet. Continue reading >>

How Diabetes Affects Wound Healing

How Diabetes Affects Wound Healing

Diabetes is characterized by the body’s inability to produce insulin and/or use it properly due to high blood glucose levels. The American Diabetes Association estimates that approximately 25 million people in the United States alone have diabetes, about 7 million of whom are undiagnosed. One of the most common complications of diabetes is chronic wounds that primarily affect the feet. Diabetes inhibits the body’s natural wound-healing capabilities, which means chronic wounds can quickly become severe and develop infections if left untreated. Diabetes affects wound healing in a variety of ways, including: Reduced circulation – High blood glucose levels can cause the blood vessels to constrict, which reduces blood flow to the extremities. Circulation is an essential part of the body’s natural wound-healing process, as the blood delivers oxygen to the wound and helps to fight infection. Neuropathy – Loss of circulation can cause nerve damage in the feet, which limits sensation. Someone with diabetic neuropathy may not realize they have developed wounds on their feet, or may be more prone to foot injuries. Immune system deficiency – High glucose levels can affect the body’s immune system, which can increase the risk of wound infection in the feet and inhibit the body’s natural healing process. You can also review our other online resources to learn more about When to Seek Professional Wound Care, Seven Tips for Preventing Foot Sores, and Nutritional Guidelines for Wound Care. Diabetic Wound Treatment in the Tampa Bay Area If you are suffering from diabetic foot ulcers, BayCare offers a variety of advanced wound treatments at our Tampa Bay area wound care centers. Treatments include hyperbaric oxygen chamber therapy, bioengineered wound grafting, total conta Continue reading >>

How Diabetes Affects Wound Care?

How Diabetes Affects Wound Care?

There are currently 21 million Americans living with diabetes, and of those, 15% will develop a foot ulcer. Foot ulcers are the most common chronic wound to develop in patients with diabetes due to reduced blood flow and damaged nerves. Diabetic foot ulcers are a major cause of hospitalizations and additional healthcare expenditures within this population. Understanding how to identify and treat chronic wounds is an important step in preventing the development of other complicated health issues in patients with diabetes. The main challenge is the body itself. Slow healing that occurs with patients with diabetes can easily turn chronic wounds into life-threatening situations. Here are several factors that contribute to slow healing: Poor Circulation Diabetes can impair blood circulation and wound healing by narrowing the arteries that carry blood to the legs, inhibiting the ability of red blood cells to deliver nutrients to the tissue. This combination is extremely serious because a non-healing wound on your foot or leg can develop into an ulcer (deep sore) that quickly becomes infected. For many diabetic patients, amputation becomes the only option. Hyperglycemia (High Blood Glucose) A high glucose count reduces the levels of the nitric oxide in blood vessels, which increases the risk of high blood pressure and eventually leads to the narrowing of blood vessels. When blood vessels narrow, oxygen delivery is limited (hypoxia) below tissue demand, and healing can become severely impaired. Prolonged hypoxia prompts poor communication between tissue and cells; vastly delaying delay treatment. Diabetic Neuropathy (Nerve Damage) When blood glucose levels are uncontrolled, nerves in the body are affected and patients can develop a loss of sensation. Depending on the affected n Continue reading >>

Connexins In Wound Healing; Perspectives In Diabetic Patients

Connexins In Wound Healing; Perspectives In Diabetic Patients

Skin lesions are common events and we have evolved to rapidly heal them in order to maintain homeostasis and prevent infection and sepsis. Most acute wounds heal without issue, but as we get older our bodies become compromised by poor blood circulation and conditions such as diabetes, leading to slower healing. This can result in stalled or hard-to-heal chronic wounds. Currently about 2% of the Western population develop a chronic wound and this figure will rise as the population ages and diabetes becomes more prevalent [1]. Patient morbidity and quality of life are profoundly altered by chronic wounds [2]. Unfortunately a significant proportion of these chronic wounds fail to respond to conventional treatment and can result in amputation of the lower limb. Life quality and expectancy following amputation is severely reduced. These hard to heal wounds also represent a growing economic burden on Western society with published estimates of costs to healthcare services in the region of $25B annually [3]. There exists a growing need for specific and effective therapeutic agents to improve healing in these wounds. In recent years the gap junction protein Cx43 has been shown to play a pivotal role early on in the acute wound healing process at a number of different levels [4–7]. Conversely, abnormal expression of Cx43 in wound edge keratinocytes was shown to underlie the poor rate of healing in diabetic rats, and targeting its expression with an antisense gel restored normal healing rates [8]. The presence of Cx43 in the wound edge keratinocytes of human chronic wounds has also been reported [9]. Abnormal Cx43 biology may underlie the poor healing of human chronic wounds and be amenable therapeutic intervention [7]. This article is part of a Special Issue entitled: The Comm Continue reading >>

10 Factors That Affect The Wound Healing Process All Nurses Should Know

10 Factors That Affect The Wound Healing Process All Nurses Should Know

As a nurse you’ll be seeing and caring for a lot of different wounds on the job. Naturally, you will run into patients with certain lifestyles or medications among other things that affect their skin to heal properly. Here is a compiled handy list of common factors that affect the wound healing process. Age Aging affects everything in the body and yes, that includes the structure and function of the skin. Everything slows down during the aging process, including the phases of wound healing. Functional changes in skin include thinning of the skin and a decreased inflammatory response. Thinning of the skin predisposes the elderly to injuries and fragility. There are a few physical findings in the elderly that affect their ability to heal normally within the layers of the skin: Epidermis: Decreased thickness in the epidermal layer that causes an increased transparency and fragility Decrease in cell replacements means a delay in wound healing Decreased number of Langerhans cells Change in the shapes and sizes of the keratinocytes Dermis Dry skin brought on by a decrease in dermal blood flow Decreased dermal thickness, which causes a paper thin, transparent appearance, increasing the risk of pressure ulcers Nutrition It is vital that the patient has a great intake of proper nutrition to promote healing. The wound is unable to heal properly if the patient lacks the necessary nutrients to maintain adequate energy for collagen synthesis. Obesity A patient who weighs 20% greater than their ideal body weight has a greater risk of infection leading to an interruption of the healing process. Nurses can reduce the risk of complications by encouraging the patient to utilize a binder or splint over the incision during straining or coughing. Presence of Debris, Necrotic Tissue, and I Continue reading >>

Mechanism Identified Behind Impaired Wound Healing In Diabetics

Mechanism Identified Behind Impaired Wound Healing In Diabetics

A molecule has been identified by researchers at the University of Pennsylvania School of Dental Medicine that may explain why wound healing is impaired in people with diabetes. The scientists behind the discovery believe the molecule may also offer a new target for therapies that could improve healing. About 15% of diabetics will have a non-healing wound at some point in their lifetime, and in some cases, these non-healing open ulcers can be so severe that they lead to amputations. In 2013, a study found - contrary to previous research - that the Foxo1 molecule promotes healing by both protecting cells against oxidative stress and inducing a molecule called TGF-β1 that is critical for wound healing. The Penn team wanted to investigate whether these mechanisms are also implicated in the reduced capacity for wound healing among people with diabetes. To do this, the researchers first created small wounds on the tongues of mice with diabetes and a control group of non-diabetic mice. The wounds of the diabetic mice - as might be expected - healed more slowly than the control mice. The team then repeated this experiment in mice bred to lack Foxo1 in a type of cell called keratinocytes, which "fill in" the holes left by injuries. The researchers were surprised to find that the absence of the Foxo1 protein and FOXO1 gene in the keratinocytes appeared to cause the diabetic mice to heal more quickly. Next, the team experimented with cells in culture. The researchers found that cells grown in a "high-sugar media" were less able to move and proliferate, compared with cells grown in standard solution. The same slowed proliferation of cells was observed by the researchers in diabetic mice; because the cells were slow to proliferate, they closed the wound over the keratinocyte filli Continue reading >>

How Heart Health Affects Wound Healing

How Heart Health Affects Wound Healing

Chronic wounds affect approximately 6.7 million people in the United States. Chronic wounds affect approximately 6.7 million people in the United States. If left untreated, chronic wounds can lead to a diminished quality of life and possibly amputation of the affected limb. The cost to treat these wounds exceeds $50 billion annually. While there are several factors that can affect wound healing, heart health is one of the most important. Coronary artery disease, peripheral arterial disease (PAD) and other issues with the heart and vessels can cause obstructions that hinder the flow of blood, oxygen and nutrition to the wound. Cholesterol, diabetes, stroke and high blood pressure can also affect the health of your heart. Coronary artery disease, also known as ischemia, is when plaque grows within the walls of the coronary arteries until the blood flow to the heart is limited. Peripheral arterial disease is a condition that develops when the arteries that supply blood to the internal organs, arms and legs become completely or partially blocked as a result of atherosclerosis. To avoid these conditions, it is important to keep your heart healthy. The Franciscan St Elizabeth Health Advanced Wound Care & Hyperbaric Medicine Center® offers the following tips to live a heart healthy life. Live an active lifestyle with 30 minutes of exercise on most days. Don’t smoke or use tobacco of any kind as it is one of the most significant risk factors for developing heart disease. Eat a diet that is heart-healthy. This includes lots of fruits, vegetables, whole grains, beans and other low-fat sources of protein. Maintain a healthy weight. Obesity can lead to high blood pressure, high cholesterol and diabetes. All of these chronic conditions can lead to heart disease. Ensure you get qu Continue reading >>

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