Why Diabetic Wounds Heal Slowly? The Reasons And How To Prevent

Diabetes And Wounds - Reasons Of Slow Healing - DoctorOnCall

Diabetic patients often suffer from wounds that are difficult to heal, with the condition being especially true for long term diabetes patients who have suffered the disease for many years. This is among one of the many symptoms of diabetes, but is one of the most dangerous. 

In general, the risk of a diabetic suffering such a wound increases by 30% every decade or so. There is also the risk of developing diabetic lesions, the chance of which increases significantly in untreated diabetes cases. Other than that, diabetic lesions usually occur on the soles of the feet, sometimes only noticed after pus or gangrene formation. This condition is known as diabetic foot ulcers.

Why Diabetic Wounds Heal Very Slowly?

A diabetic's wounds tends to heal at a slow pace, and they are at risk of the injury progressing to the point where amputation of the limb is required.  Unfortunately, this happens because of several factors involved in diabetes mellitus.



1. Nerve Damage or Neuropathy

Uncontrolled or untreated diabetes has the potential to cause severe nerve damage. It can start from the peripheries and soles of the feet, then slowly spread towards the trunk of the body, and finally cause patients to have a mitigated sense of heat, cold or pain. The absence of these sensations is also known as diabetic neuropathy.

Neuropathy can also indirectly lead to more health problems, as the wound has the potential to go unnoticed and even become infected. In the worst case, the would can even progress to the point of purulent, where pus would ooze out of the wound.

2. Poor Blood Flow

This specific condition is also known as peripheral arterial disease, and its definition not only applies to poor blood flow in the legs but also in the arms as well. 

Diabetes also affects the inner tissue lining in blood vessels, which has the potential to cause poor regulation and prevent proper and sufficient blood flow to the affected area. This not only causes pain but slows down the healing process as well. In addition, diabetes also causes blood vessels in the soles of the feet and legs to become narrow and inelastic. Poor blood circulation also increases the risk of foot infections.

3. Poor Immune System

Diabetic patients have a weakened immune system.

Because of this, the immune cells responsible for triggering a response in regards to the wound is inefficient, slowing down the healing process. This delay in response drastically increases the chance of infection in the patient. 

But a weakened immune system poses more danger than mere wounds. It also makes a person more susceptible to bacterial infections, and if a diabetic person were in danger of this, the body will prioritise fighting off the infection. This means that the diabetic wound would be further delayed. More serious complications that can occur from this include sepsis and gangrene.

4. SkinChanges

Diabetes mellitus will cause the skin of the soles and balls of the feet to become dry, cracked and flaky.

A callus is formed more easily and rapidly due to this phenomenon. Therefore, a new wound or boils form more often on the heel or ball of the foot or on the bottom of the big toe.

5. Deformity

Diabetic neuropathy may also lead to foot deformities and result in loss of function.

Any Individual with foot deformity due to diabetes mellitus and/or pre-existing deformities such as hammer toes, overlapping toes or bunions are more likely to be infected and injured.

How to Take Care Of Diabetic Wounds?

1. Keep The Wound Clean

Those with diabetes mellitus are advised to clean any wounds they have immediately.

Use running water and soap or any antiseptic cleansing product available to clean any wound. After making sure the wound is dry, apply any topical antibiotic to ensure the wound is free from infection. Remember to change the wound dressing regularly to ensure it stays clean and dry. Discard any soaked dressing, as it only serves to slow down the healing process. The moisture and dampness of a soaked dressing also has the potential to introduce infections. 

2. Make Sure The Wound Dressing Is Not Overtightened

Avoid excessive pressure over the injured lesions or wound by not tying the wound dressing too tightly.

This allows for efficient blood flow and helps the wound heal faster and better. Besides promoting blood flow for healing, it also can avoid more severe problems due to diabetes mellitus.

3. Control Your Blood Glucose Level

Uncontrolled blood sugar levels will affect the wound healing process.

Therefore, controlling blood sugar levels is essential. You can do so through adopting a healthy diabetic diet, regularly exercising, and taking diabetic medications as well as insulin injections as required. It is also recommended to consult a doctor for any additional enquiries or questions you might have regarding how to to maintain your blood sugar levels to a healthy degree.

4. Monitor For Signs Of Infections

Infections in diabetic wounds may occur without symptoms.

However, a person with an infected wound will still experience certain signs of infection. For example, fever, pain, redness, swelling, or the local rise of temperature in the skin around the wound. A diabetic wound can be classified into various degrees of severity, and it is important to take the necessary steps according to the degree of infection. 

5. Consume a Nutritious Diet

It is highly recommended to have a healthy diet and ensure daily nutritional intake to promote the healing of a diabetic wound.

Protein is an important nutrient and particularly relevant to the process of wound healing. It promotes the cell growth within body necessary to facilitate healing. But it's not just that, but other nutrients, such as fat, fibre, and vitamins, as well as your calories intake are equally important as well. 

6. Routine Health Care Follow-up

Schedule appointments and follow-up check ups routinely.

This allows health care professionals such as doctors, nurses or medical assistants to examine your diabetic wounds and monitor the progression of its healing. There are diabetic wound cleansing treatments available to be provided as well. If there is any need for modification of the current diabetic treatment plan, it can also be done during the appointment.

How To Prevent A Diabetic Wound?

There are several situations and factors that can cause the formation of a new diabetic wound. However, diabetic patients can take some measures to prevent the emergence of such wounds. For example:

1. Trim Your Nails

Long nails can lead to accidental injuries for diabetic patients. Although they are usually minor, they have the potential of festering into something more severe due to a person's diabetic condition.

As such, trim your nails routinely to prevent any accidental injuries. Applying lotion and moisturiser is also another preventive measure, as it helps to keep the skin moist and prevent cracked or dry skin. Alternatively, you can have a warm foot bath, which, thanks to the heat, has the additional benefit of promoting blood flow to the heat.

2. Always Check Your Sole

Any individual with diabetes mellitus will usually experience a certain degree of numbness over the feet and sole due to neuropathy.

Therefore, checking your own feet, including the soles and ball of the feet, after doing any activity or taking off your shoes is essential. This is to avoid any sores, redness or swelling that may be left unnoticed and to seek treatment as soon as possible the moment a new wound is noticed. A helpful tip to check the soles of your feet is to do so with a mirror.

3. Wear A Socks Or Comfortable Pairs Of Shoes

To avoid cuts and injury over the feet, diabetic patients are advised to protect their feet by wearing shoes or socks, whenever indoors or outdoors.

Choose and wear comfortable pairs of shoes, which have extra padding on the heel, are soft, and able to cover the entire foot. Avoid shoes that are overly tight and hard as they may cause injuries, cuts, and lesions to the feet. The same idea applies to wearing a pair of socks.

4. Practice A Healthy Lifestyle

A healthy lifestyle starts with abandoning unhealthy habits. So if you're a frequent smoker, it might be time to put out your cigarettes for good. Cigarettes will only cause your blood circulation to be clogged and reduce your blood flow, thus reducing the concentration of oxygen throughout the body. As a result, the wound will worsen and the healing process will be slow due to lack of blood flow and inadequate oxygen supply to the affected part.

Regular exercise is capable of promoting blood flow throughout the body, as well as maintaining a healthy, high protein diet. 

5. Routine Medical Follow-up

Attain regular medical checkups and monitoring to examine the legs and other limbs to prevent the development of diabetic lesions or wounds.

Doctors can also check for early signs of nerve damage, circulatory problems, wound infections, or other health complications, so that early treatment can be given immediately. In addition, doctors can also give further advice and instructions to help diabetic patients control their blood sugar levels more conveniently.


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