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Geisinger becomes the first member of Risant Health

How to avoid complications from any size wound

If you have diabetes, you know that your body doesn’t produce insulin or use it properly.

But did you know that diabetes makes it harder for the body to heal itself — even very small wounds? Knowing this can help you take steps to avoid complications such as infections, which can require emergency medical treatment, surgery or even amputation.

“People with diabetes need to monitor their body for wounds, and if found, ensure that even tiny cuts are properly treated,” explains Dr. David Phang, vascular surgeon at Geisinger Community Medical Center. “Because high blood glucose levels affect the body’s ability to heal wounds, people with diabetes are at risk for serious complications.”

He adds, “Usually, the most troublesome wounds affect the feet since these injuries may go unnoticed.”

Dr. Phang urges everyone with diabetes to inspect their feet every day for cuts, sores or calluses. “Be sure to inspect your shoes too, since a poorly fitting shoe may be the culprit. Doing these little things can make a big difference and prevent future complications.”

Taking quick, preventive action is key, he notes. “If you notice any wounds that are getting worse or showing signs of infection, talk with your doctor immediately.”

Why are diabetic wounds slow to heal? Here are 3 reasons:

1. High blood sugar

Blood sugar is more than just a number on your glucose meter. It plays a part in your energy level, medical needs and your body’s ability to heal injuries.

“The amount of glucose, or sugar, in your blood affects the body in many ways,” says Dr. Phang. “As we age, we all deposit calcium and cholesterol in our arteries, which is known as atherosclerotic disease. It’s a normal part of life. But high glucose levels disturb the micro-environment of your arteries, and when out of balance, your blood vessels can stiffen and narrow at an accelerated rate. This reduction in blood flow lowers the amount of oxygen and nutrients your cells need to function properly. If the cells responsible for wound healing aren’t functioning optimally, your wounds may worsen, and in severe cases, become gangrenous and require an amputation.”

Keeping your blood sugar level stable can help wounds and injuries heal quicker. It’s also important to stay hydrated and make sure you’re eating enough protein.

2. Neuropathy

Diabetes and high blood sugar can cause nerve damage called diabetic neuropathy. Neuropathy causes tingling and numbness, which will make it harder to feel if you’re injured.

“Pain can be a good thing; it lets you know something is wrong,” explains Dr. Phang. “If you had neuropathy and an object in your shoe was cutting your foot, you may not feel it. As a result, you may subject yourself to repetitive trauma without even realizing it. Soon, what started off as a small wound or cut can become a big issue. That’s why checking your body daily is important for avoiding future complications.”

People with diabetes should also keep their toenails trimmed short and wear comfortable shoes that don’t pinch or create blisters or sores on the feet.

3. Reduced immune system function

Your skin provides a protective barrier that prevents germs and foreign invaders from getting inside your body. When you get a cut and break that barrier, your immune system is responsible for fighting off and stopping infections.

But when you have diabetes, your body produces enzymes and hormones that make your immune system less effective. This can lead to infections that may cause diabetic wounds to take longer to heal and require medical attention.

“Your immune system operates on autopilot; in other words, you can’t control it,” Dr. Phang explains. “But you can practice good hygiene — and keep wounds clean and dry.”

Dr. Phang says the goal is to prevent the wound from getting worse, becoming infected and possibly progressing to gangrene.

One simple trick?

“Wear white socks,” Dr. Phang urges. “If you see blood or drainage on the sock, it alerts you that something is wrong.”

Understanding why wounds are slow to heal and closely monitoring your feet are important steps to prevent cuts and blisters. But they can still happen.

The good news: Slow-healing wounds can be treated by removing dead or damaged tissue, compression therapy, orthotics or hyperbaric oxygen therapy. But time is of the essence. If you notice anything out of the ordinary, talk to your doctor right away.

Next steps:

Meet David Phang, MD
Learn about vascular care at Geisinger
Learn about diabetes care at Geisinger

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