The Stalwart

Diabetes and Wound Healing: What You Need to Know

BY MICHELLE MORRIS, BSN, RN, director, ProMedica Wound Care Services


Did you know that people with diabetes have a more difficult path to wound healing? This is
because their body is not able to control the person’s blood sugar levels. When blood sugar is
heightened for an extended period, it impacts the healthy function of the circulatory, nervous,
and immune systems. All these factors impair the body’s ability to protect and heal itself.

The most common type of wound for people with diabetes is diabetic foot ulcers. When left
untreated, these ulcers can lead to infection and eventually amputation of the foot or lower limb.

According to the American Diabetes Association, 54,000 people with diabetes undergo
amputation each year, and as high as 80% of non-traumatic lower limb amputations happen due
to diabetes complications. The best defense for diabetic wound healing is prevention.

Anyone with diabetes can be impacted by a wound. Around 15 to 25% of people with diabetes
will have at least one diabetic foot ulcer within their lifetime, according to the National Institutes
of Health.

Behaviors that Increase Risk and How to Fix Them

Actions that increase a person’s risk of getting a wound include being barefoot, wearing poor-
fitting shoes and poor foot care. It is important to inspect your feet daily for redness, callouses,
and injuries. Diabetic patients usually have decreased sensation in their feet and toes, making it
easy for injury to occur and not to be felt.

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. It is important not to step on the mirror. When looking down, the bottom
of the foot will be reflected in the mirror.

Some of the best things a person with diabetes can do is to see a podiatrist about appropriate
diabetic footwear and routinely perform proper foot care. This includes washing and drying the
feet, moisturizing heels and soles, and adding powder between the toes.

Additionally, managing blood sugars and quitting smoking can help prevent diabetic foot ulcers
while having a positive impact on other aspects of overall health.

Helping the Wound Healing Process

Anyone with diabetes should seek preventative care from a podiatrist when redness on the toes
or the bony area of the foot is noticed, redness or callouses are present on the bottom of the
feet, or if the shape of the foot has changed. Seek immediate care from a podiatrist or wound
care specialist at the first identification of a wound. A primary care provider can refer to a
specialist if needed.

If a wound is present and proper medical care has been obtained, it is beneficial to use the four
golden rules of wound care that can help patients heal their wounds.

1. Stop smoking.
2. Maintain your blood sugar levels in a normal range.
3. Elevate your lower limbs to prevent swelling.
4. Most important, do not walk on your wound. See your wound care provider or podiatrist
for footwear that can offload the pressure when you have to walk.

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