While proper wound care should be a priority for all populations, for diabetics, it is even more imperative for maintaining long-term health and quality of life. It is estimated that one in every four people living with diabetes will suffer from a chronic wound at some point throughout their lifetime.
Understanding how diabetes impacts the body’s ability to heal and identifying the types of chronic wounds that diabetic patients are the most susceptible to are the first steps toward combatting this alarming epidemic and improving quality of life for diabetic patients.
Diabetes and Healing
Everyday cuts, scrapes, and other minor wounds are an unavoidable part of life. But for diabetics, these seemingly insignificant injuries can progress into serious health complications. Diabetes greatly inhibits the body’s natural ability to heal, meaning even smaller wounds are at an increased risk of infection. Even when infection does not spread, slow healing negatively impacts a person’s quality of life. Slow-healing wounds can also limit a person’s mobility and independence.
There are several aspects of diabetes that contribute to this delay in wound healing:
- Neuropathy – neuropathy is the nerve damage that results from prolonged diabetes and specifically, from having high glucose levels in the blood stream. Neuropathy typically affects the lower extremities including the toes, feet, and legs. Sensory nerve damage often leaves the affected areas numb, making it harder for diabetic patients to notice when they’ve been injured and increasing their risk of wound infection. It can also leave the patient with severe shooting/dull pain or both. Motor neuropathy affects the foot and leg muscles and oftentimes leads to foot deformity. Autonomic neuropathy dries the skin leading to cracks and fissures. Combined, neuropathy potentiates an altered gait and increase falls risk
- Poor Circulation –Patients with diabetes are more likely to have diminished/poor circulation. When the arterial flow of blood slows throughout the lower extremity, it prevents the essential nutrients required for healing from being delivered to the site of the wound. Most importantly, the amount of oxygen delivered to the wound area is limited as well. This ultimately delays the healing with new tissue, causing wounds to heal slowly or preventing them from healing altogether.
- Blood Sugar – diabetics often have increased levels of glucose, or sugar, in the blood stream. Excess glucose inhibits the body’s ability to heal and masquerades infection and the body’s ability to handle it.
While there are a variety of open wound and infection concerns for the diabetic population, foot ulcers are one of the most common chronic conditions, affecting around 25% of all diabetic patients during their lifetime. Sensory neuropathy with the loss of feeling pain, puts even a small wound at risk to go unnoticed until it becomes infected or so severe results in significant pain. Add diminished arterial circulation to the area increases the risk this wound could place the patient’s limb at risk.
In the most severe cases, these foot wounds can become so detrimental to an individual’s health that amputation of the lower-extremity is required. According to the American Journal of Managed Care (AMJC) about 230 of these amputations take place each day in the United States.
Prevention and Condition Management
Many of the chronic wound conditions diabetic patients frequently suffer from can be successfully avoided with diligent management. Those living with diabetes are encouraged to closely monitor their glucose levels, regularly inspect their legs, feet, and lower extremities for minor wounds, and to ensure their diet is one that promotes healing, healthy blood sugar levels, and healthy circulation. And when a wound is recognized, early evidence-based multidisciplinary team management is the key to healing and preventing amputation.
South Shore Health is dedicated to the treatment and prevention of chronic wounds for all populations. With nearly 10% of the southeast region population being affected by diabetes, South Shore Health’s Center for Wound Healing works closely with podiatric and vascular surgeons, diabetic condition management specialists, and our team of multi-disciplinary wound care experts in order to address the issue of chronic wound care and the diabetic epidemic from every angle.