How does diabetes affect wound healing?

People with diabetes have a more difficult path to healing wounds. This is because their body cannot control their blood sugar levels.

“When blood sugar is too high for a long time, it affects how well the circulatory, nervous and immune systems work,” explains Michael Humphries, system director, ProMedica Wound Care. “High blood sugar can slow healing, lead to chronic wounds and increase the risk of infection.

The most common type of wound for people with diabetes is diabetic foot ulcers. This is due to poor circulation in the feet. Up to a third of people with diabetes will have at least one diabetic foot ulcer within their lifetime, according to the National Institutes of Health.

When left untreated, these ulcers can lead to infection. Sometimes, this can result in the amputation of the foot or lower limb. According to the American Diabetes Association, 160,000 people with diabetes undergo amputation each year, and as high as 80% of non-traumatic lower limb amputations happen due to diabetes complications.

Prevent Wounds with Proper Foot Care

Anyone with diabetes can be impacted by a wound. That’s why the best defense for diabetic wounds is prevention.

“Individuals with diabetes may have decreased feeling in their feet and toes. This can make it harder for the person to notice an injury,” says Michael.

To prevent wounds, Michael recommends that individuals:

• Always wear shoes or slippers to protect feet, even at home
• Wearing properly fitting shoes
• Avoid narrow or pointed toe shoes
• Wash your feet daily with mild soap and water, especially between your toes
• Wear warm socks in the winter and breathable socks in the summer
• Never apply direct heat to your feet or legs (e.g., hot soaks, electric heating pads)

If you have diabetes, consider seeing a podiatrist who specializes in foot care.

“Podiatrists can give guidance on diabetic footwear. They can also help patients with proper foot care, including how to wash and dry your feet, keep them moisturized and dry with foot powder,” says Michael.

Examine Your Feet for Wounds

If you have type 1 or type 2 diabetes, it is important to inspect your feet daily for redness, callouses and injuries. A helpful tip for inspecting the bottom of the feet is to place a handheld mirror on the floor and hover the foot above it. When looking down, the bottom of the foot will be reflected in the mirror. For your safety, remember not to step on the mirror!

During your self-exams, check for blisters, sores, dry skin with cracks, changes to the skin or signs of infection.

Michael recommends seeking immediate care from a podiatrist or wound care specialist as soon as you notice a wound, or one of the following signs:

• Redness on the toes or the bony area of the foot
• Redness or callouses on the bottom of the feet
• The shape of the foot has changed

Promote Healing with Healthy Living

Your lifestyle affects how well your body can protect and heal itself. Keep these in mind to reduce your risk of wounds:

• Stop smoking, as it makes it harder for your body to heal itself.
• Keep your blood sugar levels within a normal range. This will help prevent ulcers and promote healing.
• Talk with your healthcare provider about having an A1C test to know your average blood sugar level over the last three months.
• Check your blood sugar throughout the day to better understand what affects your blood sugar.
• Elevate your lower limbs to prevent swelling, which can slow healing.
• Do not walk on your wound. See your wound care provider or podiatrist for footwear that can offload the pressure when you must walk.
• Eat nutritious foods that will help manage your blood sugar, such as high-fiber carbohydrates (e.g., whole grains, fruits, nuts, oats) and protein (e.g., legumes, fish, nuts, vegetables)
• Enjoy regular exercise to manage your diabetes and reduce your wound risk.

With proper wound care and a healthy lifestyle, you can help your body heal on its own and reduce your risk of infection.