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 nerves, symptoms of diabetic neuropathy can range from pain and numbness in the extremities to problems with your digestive system, urinary tract, blood vessels and heart. 

Immune System Deficiency
Diabetes can affect the body’s white blood cells, lowering the efficiency of the immune system. If glucose levels are high, the immune system will function less effectively, causing a greater risk of infection. These infections impede the healing process of a wound and can cause other health concerns. If an infection is not identified or is left untreated, a diabetic patient is at risk to develop sepsis or gangrene, which sometimes leads to the amputation of a limb, foot or toe.

If you, a family member or someone you know has diabetes – there are steps that can be taken to improve healing.

1. Consuming Enough Calories

Energy is needed to increase the support to the immune response and regeneration of new tissue. If patients have an existing nutritional deficiency, wound care interventions may become less effective.

Malnutrition is linked to more complications and infections, resulting in increased duration and frequency of hospital admissions. A well-balanced diet that incorporates the macronutrients — carbohydrates, protein, and fat — provides the balance necessary to maintain overall health. 

2. Encouraging Weight Loss (As Needed)  

Changes to diet and physical activity levels are recommended to facilitate weight loss, which is a proven means to improve glycemic control and reduce complications. 

3. Fuel Up With Carbohydrates

Carbohydrates are the main and first source of cellular energy during wound healing. A diet with sufficient carbohydrate calories prevents the oxidation of protein for energy. Distribute carbohydrates evenly throughout the day to prevent fluctuations in blood sugar. 

4. Protein for Healing

Protein provides the foundation for tissue growth, cell renewal, and repair resulting from a wound. Insufficient dietary protein can slow the rate and quality of wound healing. 

5. Supplementing (When Necessary)

Encourage whole, fresh foods — they offer all of the required nutrients for wound healing, along with the additional benefits of phytonutrients and antioxidants.

These are just some of the steps that can be taken to prevent chronic and life-threatening wounds in diabetics. However, there is nothing more powerful than knowledge. Knowing what to look for and how to deal with issues that face healthcare today is why Diabetes Awareness Month is so important.

Please share this article and the following video to spread the word about the diabetes crisis. Only together can we make a difference.

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