Ask An Expert: Diabetics' Wounds

Content provided by the Faculty of the Harvard Medical School

Ask An Expert: Diabetics' Wounds

Question:

Why don't diabetics' wounds heal normally?

Answer:

Most of the time when a diabetic has a wound or sore that does not heal quickly, the wound is an ulcer on the foot or leg. Wound healing in this case is slowed by two complications of diabetes: abnormal circulation and decreased ability of nerves to feel sensation (peripheral neuropathy).

It is very common for people with diabetes to have atherosclerosis (cholesterol deposits in the arteries), and this causes narrowing of the arteries that lead into the legs and feet. A wound that is healing needs to have plenty of oxygen and plenty of nourishment. Artery disease can slow down delivery of oxygen, so it can slow down healing of a wound.

Nerves play a very important role in wound healing. If a wound is sensitive (such as a sunburn), you will make sure that you don't rub it or bump it accidentally. It is common for people with diabetes to have numbness in the feet or lower legs from peripheral neuropathy. Neuropathy can make wound healing slower, since a person with decreased feeling won't notice as quickly if something is pressing against or rubbing against an ulcer.

In addition, people with diabetes can have depressed immune system function, particularly when their sugar levels are high. Without normal immune system function, wounds may show delayed healing.

Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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