STONE: Wound healing often more difficult for diabetics

We’ve all experienced different types of wounds during the course of our lives from a simple scrape on the knee, a mishap with a kitchen knife, or even a planned surgery. Wounds come in all shapes and sizes and can be expected or unexpected.

By definition, a wound is any injury to living tissue from a cut, blow, or impact often resulting in a break, or opening of the skin. And with skin being our first line of defense against harmful bacteria and other infectious agents, it’s important to treat wounds appropriately to minimize the risk of infection. But, for people with diabetes, even the most benign wounds can mend slowly, or become progressively worse making the process of healing even more challenging.

What makes diabetes so challenging is that it impacts the body’s ability to heal effectively and it all starts by how well blood sugars are controlled. Chronic, or prolonged, elevation of blood sugars causes arteries to narrow and even stiffen which negatively impact blood flow throughout the body.

Since we rely on vital, nutrient and oxygen-rich blood to help feed organs and tissue, any disruption of this flow limits this process which included the efforts to heal wounds. Without sufficient blood flow, wounds can take much longer to heal — or worsen because they body cannot “keep up” to stave off and fight the infection.

Circulation isn’t the only problem diabetes creates. Uncontrolled blood sugar will also cause considerable damage to nerves particularly in the lower extremities such as toes, feet and legs.

Known as diabetic neuropathy, high blood sugar damages nerve cells to the point of them no longer functioning properly, or at all, leading to the loss or ability to feel sensations or pain.

Unfortunately, when one can no longer sense pain they may not know damage has occurred until it becomes too late. Therefore, diabetics should inspect their skin — head to toe — paying particular attention to feet and hands for any skin breakdown.

For diabetics, every wound is a concern and requires immediate attention. Wounds can go from bad to worse in a very short amount of time, meaning the longer a wound is left untreated, the more likely infection will set in.

Unfortunately these infections can progress beyond the wound itself, migrating rapidly to surrounding tissues such as bone, or even becoming septic, once the infection enters the blood stream and internal organs.

As it advances to this stage, even the most aggressive of treatments cannot compete against the infection leading to more extreme measures such as life-altering, but potentially life-saving, limb amputation. As a result, overall mobility can be impacted, setting a cascade of events further increasing risks of developing additional wounds and complications.

If you have diabetes and develop a wound, it doesn’t mean doom and gloom is around the corner. However, exercising a bit more diligence and less procrastination will better ensure the healing of those wounds.

Ultimately, it all begins with how effective blood sugar is controlled. Aside from eating a healthy diet, getting plenty of exercise and following your doctor’s prescribed therapies, frequent blood glucose checks are not only necessary, they’re a must. Take action right away to get back to normal limits and communicate with your doctor frequently to modify your treatment as necessary. And since the majority of complicated wounds involve the feet, include these additional wound prevention efforts daily:

>> Wear socks that provide adequate padding and also wick away moisture. Opinions on types of socks and any fabric or fabric blends vary among healthcare professionals. Several choices are available including cotton, wool, acrylic, or any combination thereof.

>> It is very important to make sure you are wearing shoes that fit properly. Check the interior of your shoe for areas that may rub your foot, creating sores or reddened spots.

>> Examine your feet by checking the bottom of your foot for any calluses, blisters, and/or reddened areas, as these may be signs of impending trouble. If your flexibility is limited, place a small mirror on the floor to visualize the bottom of your feet. If you notice any change such as an open wound, increasing redness, numbness, calluses, or blisters, contact your physician immediately to make an appointment for further evaluation.

>> Keep toenails trimmed. Do this by trimming the nail straight across and avoid cutting them too short. Cutting the nail at a curved angle can cause the nail to lodge itself in the skin, causing pain, discomfort and infection.

>> Wash your feet and dry them carefully, especially between the toes.

>> Moisturize your feet but avoid lotions/gels between toes as this can lead to fungal infections.

According to the American Diabetes Association, approximately 30.3 million Americans have diabetes and are more susceptible to complications from wounds. By taking a few minutes per day to follow these simple preventive steps, people with diabetes ensure themselves a healthier outlook in wound prevention and management.