Who hasn’t heard about diabetes and healing? The pathology is increasingly prevalent in society. According to the IDF , there are approximately 500 million adults diagnosed with this disease worldwide. Given this, health professionals need to direct the population to a change in habits.
But what happens when this does not occur and the person with diabetes does not adhere to treatment? What if the glycemic level remains high? In these cases, complications manifest, either in the long term or in the short term. . One of them is poor healing, which mainly results in ulcerations. You can already imagine the impact of this on people’s lives, right?
With that in mind, let’s talk a little more about the relationship between diabetes and healing, clarifying the process and ways to minimize the impact. Check out!
How does the healing process take place?
Before we talk about why diabetes interferes with the healing process, let’s understand what are the steps involved in it. Follow up!
The initial phase of the healing process is hemostasis, which occurs shortly after the injury. It is characterized by the contraction of blood vessels, which do this to stop bleeding. To prevent unwanted microorganisms from entering the wound, such as bacteria, your body forms a clot. It is formed by red blood cells, whose one of the functions is to help in the defense of the organism.
In short, the skin can lose continuity, as in cases of cuts or bruises. In this case, the body’s cells mobilize to stop the bleeding and ensure that the skin returns to its previous state. This process, called hemostasis, seeks to maintain blood flow in order to control clotting and bleeding.
When your skin loses continuity, as in cases of cuts or bruises, your body’s cells mobilize to stop the bleeding and ensure that the skin returns to its previous state. This process, called hemostasis, seeks to maintain blood flow in order to control clotting and bleeding.
The first cells involved in this are platelets, which are present in the blood and at all times check the integrity of the vessels. When they identify a lesion, they adhere to the site and aggregate with each other. In this, there is the release of a series of pro-inflammatory factors, which will mobilize more and more cells in the inflammatory process.
Concomitant to this, there is the formation of fibrin, a protein that, together with platelets and red blood cells, forms clots. And it’s those clots that stop the bleeding from continuing.
The proliferation phase is the time to recover the integrity that the skin lost during the injury. And, for that, it depends directly on an ideal environment for the proliferation of some important cells.
You must have heard about collagen, right? It is one of the structures that ensures skin consistency, in addition to cells called fibroblasts. Oxygen is also essential at this stage, as well as other nutrients found in the bloodstream. All these elements contribute to skin regeneration.
Finally, after collagen and fibroblast deposition, remodeling of the injured site begins. At this point, the excess structures undergo the natural process of cell death. Thus, little by little, the skin will acquire the appearance it had before.
How does blood glucose influence this process?
Now that you understand how healing occurs, step by step, we can explain how hyperglycemia impairs this process. Check out!
Red blood cell failure
Remember the cells involved in clot formation? One of them is the red blood cell, whose main function is to transport oxygen. Therefore, it is extremely important that its flow through the vessels is maintained, both for the formation of the thrombus and not to leave the interior of the vessel deficient in oxygen.
To perform these roles so well, red blood cells need energy, which is obtained through glucose. Glucose molecules, on the other hand, are very heavy. So, when in excess, they result in a denser red blood cell, with greater difficulty to maintain its flow through the vessels.
This denser locomotion makes the healing process difficult, as it causes damage to the amount of oxygen available in the injured region, in addition to hindering the capture of red blood cells to compose the clot. This negative impact occurs in the inflammatory and proliferative phase.
Decreased availability of oxygen
Another complication that hyperglycemia causes at the time of healing is ischemia, that is, the decrease in oxygen availability. The consequence of this is also a decrease in nitric oxide, whose role is to increase blood flow and combat reactive oxygen molecules.
Such molecules, when present, cause tissue injury — that is, damage other cells — and can further contribute to ineffective healing. After all, the inflammatory phase and hemostasis were impaired. Thus, there is also a greater difficulty in fighting infections, which makes healing slow and exposed to complications.
How does healing contribute to the onset of diabetic foot disease?
You have already noticed that people with diabetes have a greater difficulty in healing. Health professionals explain this by the absence of oxygen and nutrients necessary for this process, as the concentration of glucose in the blood impaired this. Given this context, it is possible to develop diabetic foot disease.
This is because the patient with diabetes decreases sensitivity in the nerves, the so-called neuropathy. Thus, it is more difficult to find out if any part of the body has been injured, which contributes to the advancement of the wound.
This type of problem is more common in the extremities of the body, such as the feet. Doctors also explain this because the tissue in this region is thinner. Therefore, there is a greater risk for the emergence of infections and ulcerations. And the seriousness of this can be seen in numbers: ulcers precede 85% of amputations .
That is, the impairment of nerve fibers causes the person to gradually lose sensitivity in the lower limbs. In addition, there is a weakening of the muscles and the appearance of fissures . And all these factors favor the emergence of ulcers.
Undoubtedly, this condition is a serious public health problem and, if left untreated, can result in a significant impairment in the quality of life of a person with diabetes. It is important to keep an eye on this because the wounds caused in the region occur routinely. For example, when wearing tight shoes, injuring with nails, stones, sharp objects, etc.
What are the types of diabetic wounds?
To better understand the relationship between diabetes and healing, learn about the types of diabetic wounds caused!
This is the type of wound that intensifies when the patient loses sensation in the nerves. So, he tends not to notice the friction between the feet and the footwear, for example, nor any other impact on the body. Therefore, the patient takes time to realize the problem and seek appropriate treatment.
In this case, the wounds are caused by vascular and peripheral diseases, which impair arterial circulation. In this context, the body may have difficulty in blood circulation. Thus, the consequences tend to be tissue necrosis, infection and even amputation. When this occurs, parts of the body, such as the foot, tend to become pale and cold.
In some situations, the person with diabetes suffers from both types of wounds, vascular and neuropathic. In this case, the condition is called a mixed wound.
How to minimize the impacts of diabetes on healing?
Considering what has been discussed so far, the first step to not suffering from impaired wound healing is to keep blood sugar levels at adequate values. . This not only removes the complication of ulcers, but also prevents visual, kidney, cardiovascular damage, among others.
Once the person notices an ulceration, it is necessary to classify it. Thus, it is possible to identify whether the underlying problem is neurological or vascular. Then, an assessment should be made for infections; if any, it is essential to treat them immediately, according to their severity.
In any case, medical follow-up is essential to know the ideal levels of sugar in your blood and minimize possible damage to nerves and vessels — in addition to receiving guidance to prevent ulcer recurrences, such as the use of suitable shoes.
Considering the treatment, a multidisciplinary work is necessary, with the help of the nursing team, in order to maintain the necessary care with the injuries and avoid the development of infections or, in more severe cases, amputations.
How to avoid diabetic wounds?
In short, more important than treating the condition is preventing its appearance. That’s because hyperglycemia doesn’t just impact healing; in fact, several organs are harmed by it. Therefore, it is important to ensure control of the disease.
This is possible by maintaining healthy habits, such as a balanced diet . , exercising , having periodic exams, avoiding smoking and drinking alcohol . , etc. All this is useful for the person to be able to control glycemic levels and avoid complications, such as difficulty in wound healing.
In addition, there are specific foot care that a person with diabetes can follow. It is the case that the patient himself inspects it frequently to identify changes. This is true for both small and larger wounds. Also, ensure foot hygiene, frequent nail clipping and the use of appropriate shoes.
Do you understand the relationship between diabetes and healing? The disease requires adequate care so that the patient does not suffer complications. As seen, once they advance, it becomes more difficult to think of a treatment. Therefore, follow the above recommendations.
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