Diabetes

Nancy Munoz's picture
Nutrition Management

by Dr. Nancy Munoz, DCN, MHA, RDN, FAND

The presence of diabetes can contribute to a decreased wound healing rate. Increased glucose levels can stiffen the arteries and contribute to narrowing of the blood vessels. This can contribute to pressure injury development and is a risk factor for impaired wound healing.

Diabetes is an illness in which the individual’s blood glucose level is above the established range. Glucose is present in the foods we eat. Most foods contain a blend of carbohydrates, proteins, and fats. The amount of each of these nutrients in the foods we consume determines how quickly the body transforms food into glucose. For instance, consuming carbohydrates affects blood glucose levels one to two hours after the meal. Ingesting protein has very little influence on blood glucose levels, and the glucose from the fat in foods is slowly absorbed and does not contribute to increase glucose levels.

WoundSource Practice Accelerator's picture
Patient with oxygen mask

by the WoundSource Editors

When developing the plan of care for the patient with a chronic wound, it is imperative first to look at the "whole" patient and not just the "hole" in the patient.1 As we do, we are able to review any medical conditions or disease states that may affect wound repair and healing. Millions of Americans are affected by chronic wounds each year. These wounds include causes such as diabetic foot ulcers, venous leg ulcers, arterial insufficiency, and pressure ulcers. Common comorbid conditions that can affect healing include diabetes, venous insufficiency, peripheral arterial disease, cardiopulmonary and oxygen transport conditions, immune deficiencies, and dementia.2 This discussion is focused on these conditions and factors that contribute to chronic wounds and their management.

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Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

Diabetes mellitus is frequently associated with chronic non-healing wounds, many of which result in amputation. The combination of peripheral vascular disease, neuropathy, and impaired immune function contributes to a higher risk of injury and deficiency in healing. Wound healing is a complex process comprising eight important factors: (1) collagen synthesis, (2) cell migration, (3) cell cycle and differentiation, (4) angiogenesis and growth hormone, (5) blood clotting, (6) extracellular matrix and focal adhesion, (7) calcium ion signaling, and (8) immune and inflammatory response. In the diabetic cell, all these processes malfunction, with the exception of collagen synthesis, cell migration, and cell cycle or differentiation.

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WoundSource Editors's picture
Diabetes and wound healing

For individuals with diabetes, all wounds are a serious health concern and require careful attention. Because of diabetic peripheral neuropathy, skin cuts and blisters often go unnoticed until they become more complicated to heal. In addition, internal wounds such as ingrown toenails, skin ulcers, or calluses can cause breakdown of tissue and an increased risk of infection. Even small cuts and insect bites can cause wound healing difficulties in patients with diabetes. Here are common factors of diabetes that impact wound healing:

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Janet Wolfson's picture
patient interview questions

by Janet Wolfson PT, CLWT, CWS, CLT-LANA

I was recently listening to one of my favorite news sources, NPR, enjoying an interview with James E. Ryan, the author of "Wait, What? - and Life's Other Essential Questions". The premise was that asking the right questions can lead to a happier and more successful life. A physician called in to relate that this was something he had been doing in his medical practice. I couldn't have agreed more – the questions I ask my patients (and then listening to their answers) can go a long way toward making an intervention in their health care more successful.

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Michel Hermans's picture
Year in review

by Michel H.E. Hermans, MD

At the beginning of a new year, many look back at the previous one in an attempt to analyze what happened, whether it was good or bad or perhaps even special.

From a chronic or acute wound healing point of view, 2015 was not particularly special. Yes, a number of new dressings and techniques were launched at the different conferences, but none of them really established a breakthrough with regard to new clinical data or a totally new approach to many of the still unsolved problems that exist in healing wounds.

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Temple University School of Podiatric Medicine's picture

by Tedman L. Tan and James McGuire DPM, PT, CPed, FAPWHc

The management of diabetic foot ulcers is becoming an increasingly significant concern with the growing population of patients with diabetes in the United States. Most amputations involving the lower extremity in patients with diabetes are preceded by foot ulcers, and in turn, lower extremity amputations are associated with a high 5-year mortality rate at around 45% among individuals with diabetes.1 Therefore, diabetic foot ulcers require special attention due to the possible life-threatening complications associated with such wounds.

WoundSource Editors's picture

by the WoundSource Editors

The term diabetic foot refers generally to the increased occurrence of complications in the feet of patients with diabetes mellitus. The most common foot problems related to diabetes are peripheral neuropathy leading to ulceration, vascular disease, increased risk of infection, and deformities like Charcot arthropathy. Complications arising from diabetes are the most common non-traumatic injury to cause lower extremity amputation.

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Mark Hinkes's picture

by Dr. Mark Hinkes, DPM

On June 27, 1991, the International Diabetes Federation (IDF) and World Health Organization (WHO) proclaimed the first World Diabetes Day. Today, World Diabetes Day is celebrated worldwide as an acknowledgement of the condition, symptoms, complications, treatment and resolve to find a cure for the disease. Participants in the celebration include 230 member associations of the International Diabetes Federation in more than 160 countries and territories. All Member States of the United Nations as well as other associations and organizations, companies, health care professionals and people living with diabetes and their families also observe World Diabetes Day. World Diabetes day will be celebrated on Friday, November 14th this year.

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Lindsay Andronaco's picture

by Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Many people do not realize that the two most common issues we see in hyperbaric oxygen (HBO) therapy patients are ear/barotraumas and a decrease in their blood glucose level. In general, HBO is very well tolerated and requires little other than a commitment to the treatment series.

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