Diabetes, a chronic metabolic disease characterized by high blood sugar, affects different organ functions adversely. This includes the ability of the patient to recover from cuts, burns, or other injuries at a normal pace.
People with diabetes tend to have a slower healing process due to multiple factors triggered by high glucose levels in the blood, such as delayed blood circulation, the inability of white blood cells to fight off infection and close up the wounds, as well as diabetic neuropathy causing numbing in the affected areas.
Without proper care and treatment, unattended wounds could lead to leg amputation. Find out more about the low healing capacities associated with diabetes in the next few lines.
Pro Tip: Are you at risk for diabetes? If this is the case, take the Comprehensive Diabetes Profile Blood Test to diagnose the condition early.
How Does Diabetes Affect Wound Healing?
About 25% of those diagnosed with diabetes mellitus suffered from slow wound healing that usually leads to leg amputations. In addition, high blood sugar impedes proper healing as it affects blood flow, immune responses, and nerve functions.
To better understand how diabetes affects wound healing, it’s best to know how tissue healing occurs.
Normal Healing Process
When the skin experiences cuts or injuries, the platelets prevent further bleeding by forming a clot that acts as a plug to stop the blood from gushing out of the tissues. Then, the white blood cells respond to prevent infection.
Once all these troubles are under control, the red blood cells provide the oxygen and nutrients to promote collagen building which becomes the foundation for the new tissues.
Slow Wound Healing in Diabetics
People with diabetes either produce less insulin – the hormone that processes sugar into energy – or loses the ability to process insulin. As a result, high sugar levels in the blood interfere with the functions of the blood cells during the healing process.
Specifically, the following consequences of diabetes are attributed to slow healing, which eventually leads to diabetic foot ulcers.
Slow Blood Circulation
Blood flow has a slower pace among people with diabetes, as highlighted in a study published in the Experimental and Clinical Cardiology Journal. For this reason, cells responsible for healing also have reduced rates in their functions.
In the same way, poor circulation seems to be more common in the legs, feet, and ankles, which are the areas farthest from the heart. So, if the wound is situated in the lower limbs, the healing occurs slower than it should be.
Impaired Immune Response
The rapid expansion of the wound only exacerbates the poor tissue regeneration among individuals diagnosed with diabetes. This is because the white blood cells move slowly in the injured area, increasing the risk of infection. As a result, the tissue damage worsens, and the red blood cells can’t aid in the repair.
Research highlighted vascular problems in diabetes, specifically retinopathy and neuropathy, as adverse effects used to gauge the severity of the disease. Retinopathy involves damage in the blood vessels connecting to the retina, which could impair vision. In comparison, neuropathy or nerve damage can be linked to delayed wound healing in diabetes.
Those with peripheral neuropathy feel numbness, particularly in their feet and legs. This leads to bruising, cuts, and injuries that the patient fails to feel or notice. In addition, since the wound is sustained without immediate treatment, it could eventually develop into diabetic foot and leg ulcers.
Complications of Untreated Diabetic Wounds
When diabetic wounds are ignored, it will lead to further health complications that could be life-threatening or cause physical disabilities.
Individuals with slow-healing diabetic wounds become prone to infections and gangrene. When these conditions are not treated, the worst and only solution could be amputation, wherein the affected lower limb part is surgically cut off.
An untreated diabetic wound will only increase your risk for more infections. In addition, this leads to considerable tissue damage affecting nearby areas on the skin in the form of abscesses and cellulitis.
Moreover, the infection could also penetrate the muscle and even the bones leading to osteomyelitis and tendonitis.
If the infection crosses with diabetic neuropathy, the patient becomes unaware of the injuries for a long time. In that case, the condition can exacerbate into sepsis – a fatal immune response against infections causing severe tissue damage.
Sepsis, without timely medical intervention, leads to a dramatic decrease in blood pressure, resulting in organ failure. This adverse turn of events is also known as septic shock.
Without proper treatment, a superficial foot injury can turn into gangrene, wherein the blood supply is completely blocked, which causes the tissues in the affected area to die.
Contrary to popular belief, the tissues do not turn entirely green, as the name may suggest. Instead, people with diabetes who experience the condition may notice skin discoloration ranging from black, blue, red, greenish-black, or bronze. Gangrene also causes the wound to smell foul and develop pus and blisterings around the infected skin.
5 Tips To Care for Diabetic Wounds
Treating wounds if you have diabetes may be a bit tricky. On average, a cut should completely heal within a couple of weeks. But for diabetics, it could go on for a longer time.
As established earlier, wound healing is on a slower lane for those with diabetes, which means that regular wound care may not necessarily apply effectively. So with that, here are five tips to remember when treating and caring for diabetic wounds.
- Make it a habit to check your feet and legs for wounds.
If you have diabetes, you can’t rely on your own tactile sense to tell you whether you have skin injuries or not. Diabetic neuropathy could leave you numb to pain which makes you unaware of scrapes, cuts, and gush in your foot or leg. So, it’s best to check your lower limbs for these wounds daily. Make sure to look between the toes and carefully inspect the sole and ankle.
- Wash your feet with warm water.
You have to treat your skin with the utmost care, particularly your feet and legs, if you’re diagnosed with diabetes. Part of it is washing them gently with warm water, making sure that all areas are clean. Then, dry them off completely so that no moisture seeps into the toes harboring microbes that may cause infections.
- Reduce pressure around the affected area.
Pressure promotes wear and tear in your feet. Make sure you wear comfortable shoes that don’t press too much on your feet to reduce tension. Also, avoid too much walking or running when you have diabetic wounds until they are completely healed.
- Replace the dressings regularly.
Preventing further infections should be a priority if you have skin cuts. Do this by replacing your dressings regularly to prevent moisture accumulation that could harbor disease-causing germs. Your doctor may also prescribe you with special dressing designed for diabetic wounds.
- See your doctor if a scrape or cut does not improve in 48 hours.
If your wound does not get better within two days, consult your doctor for immediate treatment. In most cases, swift medical attention ensures that the diabetic sores will not worsen, causing infections and even sepsis.
Frequently Asked Questions
What Are the Types of Diabetic Wounds?
Diabetic wounds can be classified as external or internal, which describes their origin of formation.
External diabetic wounds are cuts that go unnoticed, mainly due to peripheral neuropathy. Patients often become unaware of these wounds as they lose their ability to feel pain due to nerve damage.
On the other hand, internal diabetic wounds are typically foot and leg ulcers which are open sores characterized by red craters surrounded by callused or thickened skin.
Why Is Betadine Not Used in Diabetic Wounds?
Betadine, a trade name of povidone-iodine, is not advisable in treating diabetic wounds because iodine can be toxic, not just to microbes but also to human cells. As a result, applying iodine, regardless of brand, to diabetic wounds and ulcers causes more damage irrespective of brand.
Additionally, iodine destroys fibroblasts and keratinocytes, which aid in healing. Hence, not only does it harm the affected tissues, but it also prevents the platelets from establishing foundations for the formation of new tissues.
Why Shouldn’t Diabetics Soak Their Feet?
If you have diabetes, avoid soaking your feet regularly as it could cause skin dryness leading to further tissue damage that takes a long time to heal.
Your skin will break down and become prone to cuts and scrapes in its vulnerable state. Consult your doctor first if you plan to take baths or do leisure activities involving lengthy soaking in the water.
Diabetes, in itself, is already a complicated metabolic disorder affecting multiple organ functions. Adding its unpleasant effects on your skin which potentially leads to amputation if not treated timely, makes early diagnosis more imperative.
You can protect yourself from these adverse consequences by getting tested for diabetes early and seeking immediate treatment and management plans. Then, add some critical lifestyle changes, and you can still take control of your health.