No pain, no gain? Not true when it comes to diabetes and chronic wounds
"There are no gains without pains," wrote Benjamin Franklin in The Way to Wealth. When Jane Fonda adopted her version, "No pain, no gain," in the early 1980s, she added this to her exercise-induced cheerleading: "Feel the burn." While echoed by new exercise gurus like Tony Horton, feeling the burn in regards to exercising is good. However, if you have diabetes and you feel neither pain, nor burn, there's a chance that nerve damage is the culprit -- and chronic wounds could become a concern. Put these potential problems in their place, by learning why chronic wounds occur, and how to treat them.
Nerve damage: the diabetes connection
Healthy nerves are critical for detecting pain. Chronic, high blood sugar levels can cause nerve damage -- known as neuropathy. That's why tight blood glucose control is essential for preventing both neuropathy and infection. For example, when someone's feet are numb due to nerve damage, they may not feel a cut on the bottom of their foot. If a wound or injury is not felt, the problem can worsen, and the wound may become infected.
The skin is the body's first line of defense against the outside world: It prevents infection from invading internal tissues. If infected, chronic wounds are serious enough, the infection can spread to other parts of the body. Monitor the health of your skin regularly to identify wounds, especially on the feet. The feet are susceptible to the nerve damage that makes wound healing difficult. Cleanse wounds until healed using water and an antiseptic, such as alcohol, hydrogen peroxide or an over-the-counter medication. If you notice a wound that appears to be inflamed or infected, have it checked by a doctor, as soon as possible.
Four ways to treat chronic wounds
Depending on overall health and the type and severity of the wound, a person with chronic wounds may undergo the following treatments:
- Medication therapy: Antibiotics and antifungals may be prescribed to treat bacterial and fungal infections.
- Negative-pressure wound care: Helps remove wound fluid that the bacteria use to grow.
- Arterial revascularization: This is a type of surgery that reconstructs damaged blood vessels.
- Hyperbaric oxygen therapy: This treatment reoxygenizes the tissue, which helps limit infection
What makes chronic wounds slow to heal?
According to Dr. Tammy Brady, PhD, a diabetes expert at the Linus Pauling Institute at Oregon State University, chronic high blood sugar levels can damage the capillaries and immune cells that promote healing.
Capillaries: These tiny blood vessels exchange materials, such as gas, nutrients, blood and waste products with their immediate surroundings. The damaged capillaries found in late-stage diabetes fail to deliver the needed nutrients or remove toxins from tissues, thus preventing wounds from healing normally.
Immune cells: Chronic high blood sugar damages immune cells in the blood that travel to the tissues via capillaries. These cells help fight wound infections, which promotes healing.
Chronic wounds can take weeks, months, even years to heal. The best way to prevent the development of chronic wounds is to monitor your blood sugar continually and keep it within a normal range.
American Diabetes Association, "Skin Complications"
Oregon State University, Linus Paulin Institute, "An Interview with Tammy Bray, PhD"
Islets of Hope, "Wound Care for Diabetes"