Diabetes And Wound Care: What You Need To Know

People with diabetes have a lot to keep in mind. Blood sugar, insulin, carbohydrates, doctor appointments… diabetes management is a full-time job that doesn’t offer sick time or vacation days.

With all this to keep track of, it’s easy to apply an out of sight, out of mind policy to everything else—like minor cuts and scrapes, for example. Cuts and scratches are a regular part of life for everyone, but people with diabetes will deal with the same cuts and scratches for longer periods of time and at greater risk. High blood sugar impairs the immune system’s normal response, and restricted blood flow means that injuries won’t heal as fast. Even more worrisome, someone with diabetic nerve damage may fail to realize that they even have an injury.

In extreme cases, untreated wounds that become infected could lead to limb amputation; diabetes is the leading cause of limb amputations in the United States. The key is to understand diabetes wound care and prevention long before such drastic measures are needed.

Photo: AdobeStock/soupstock
Photo: AdobeStock/soupstock

How Does High Blood Sugar Affect Healing Time?

It seems as if high blood sugar gets blamed for everything, and when it comes to slow-healing wounds, it’s once again at the heart of the problem. High blood sugar levels can cause the arteries to stiffen and narrow, and these narrowed blood vessels are less equipped to carry blood, oxygen, and nutrients to all of the body’s tissues, especially in the extremities. With a limited supply of oxygen and nutrients, wounds will take longer to heal.

White blood cells, the ones that fight off infection, will not be as able to reach wounds when there is decreased blood flow. And diabetes also lowers the efficiency of the immune system in general as immune cells are negatively impacted by high blood sugar.

Photo: AdobeStock/ugreen
Photo: AdobeStock/ugreen

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Finally, people with diabetes may not even realize they have an injury, which means of course they will be less likely to get treatment when needed. About half of people with diabetes will experience some form of neuropathy, or nerve damage. (For more about diabetic neuropathy, click here.) The link between high blood sugar and nerve damage is not completely understood, but it’s clear that high blood sugar does damage nerve fibers and lessens their ability to transmit signals to the brain.

This nerve damage occurs most often in the legs and feet, which means that feet are especially at risk for infection because a cut or sore may cause no discernible pain or sensation. Unless someone is vigilant about checking their feet for cuts and sores, a cut could easily go unnoticed, become infected, and put someone at significant risk before they are even aware there is an issue.

Photo: AdobeStock/wingedwolf
Photo: AdobeStock/wingedwolf

“NEXT” for wound prevention and treatment

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