Uncontrolled diabetes can be a great enemy of
wound healing. If your diabetes is not under control you need to be seen
by a physician or a diabetologist who will first test your blood and then
depending on your diagnosis- put you on diet control, exercises, weight
reduction or proper medications (
tablets or insulin injections) to control the blood sugar. Besides wound
healing diabetes also affects the eyes ( diabetic retinopathy), nerves
(diabetic neuropathy), kidneys (diabetic nephropathy) and other systems so that
the patient may manifest with a number of other problems which might be missed
if the diabetes is undetected.
The common test include:
fasting blood sugar
post prandial blood sugar ( two hours after a
meal)
when these tests are doubtful other tests
will help
glucose tolerance test where your body’s
ability to control the blood sugar level over a period of time is tested
HBA1c which gives an idea of the blood sugar
level control over the past three months
There are a number of reasons why diabetes
affects the wound healing and causes other problems:
a) In diabetics the small and big blood
vessels that supply the wound are diseased (diabetic angiopathy) so that
the blood flow to the wound is diminished.
b) Further the disease affects the nerves (peripheral diabetic neuropathy) and this leads to increased tissue pressure as the pain sensations that tell us to relieve the pressure are affected or absent. In fact sensory loss or inability to feel pain sensation from any cause like nerve injury can result in ulcers or wounds that progress and don’t heal. As the person does not realize or feel the pain he fails to prevent repeated injury to himself nor does he shift his position to avoid continuous pressure on a particular part of skin.
c) The immune system is affected in diabetes (decreased neutrophil function) so that there is a greater chance for germs (microorganisms) to attack the wound and cause infection.
Many patients present with non healing wounds without prior history of diabetes.
b) Further the disease affects the nerves (peripheral diabetic neuropathy) and this leads to increased tissue pressure as the pain sensations that tell us to relieve the pressure are affected or absent. In fact sensory loss or inability to feel pain sensation from any cause like nerve injury can result in ulcers or wounds that progress and don’t heal. As the person does not realize or feel the pain he fails to prevent repeated injury to himself nor does he shift his position to avoid continuous pressure on a particular part of skin.
c) The immune system is affected in diabetes (decreased neutrophil function) so that there is a greater chance for germs (microorganisms) to attack the wound and cause infection.
Many patients present with non healing wounds without prior history of diabetes.
A
non healing wound is often a pointer to the onset of diabetes or undetected
underlying diabetes.
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