Perhaps you’re checking your blood sugar before dinner and notice yellowish pus coming from a scrape on your hand that’s been there forever. Maybe you’re watching your son – newly diagnosed with type 1 diabetes – swing on the monkey bars, and you see that the cut on his leg is still inflamed after two weeks. You may wonder, is this normal for wound healing or are things taking too long?
Normally, wounds should be well into the healing process within a couple weeks. But some medical conditions, like diabetes, can slow down the healing process and make infections more likely.
The good news is that there are ways for people living with diabetes to promote wound healing. Read on to learn why diabetes can make sores and wounds heal more slowly and what you can do to speed up the process.
Why does diabetes cause slow-healing wounds?
Having diabetes doesn’t necessarily mean that you’ll have slow-healing wounds like chronic diabetic foot ulcers. However, there are certain factors that make it more likely you’ll have healing problems.
High blood glucose levels
If you have diabetes, your body doesn’t know how to effectively control your blood glucose, or blood sugar, on its own. If your blood sugar levels are consistently high, it can lead to problems with circulation, nerves and immune system – all of which can get in the way of good wound healing.
If you have poor circulation, it can take longer for wounds to heal. That’s because it’s harder for blood to get to the wound site to fight off infection and help with the rebuilding process.
One reason for poor circulation is the thickness of your blood. If you have high glucose levels, your blood is thicker, making it harder for your heart to push it from the tips of your fingers to the ends of your toes
People with diabetes are also more likely to have plaque buildup in their blood vessels. This buildup narrows blood vessels, making it harder for blood to squeeze through. Many people living with diabetes also have peripheral vascular disease, which is reduced blood flow to your arms and legs.
People living with diabetes sometimes have neuropathy, a condition that affects the nerves and can result in the loss of feeling. Diabetic neuropathy is caused by blood sugar levels that are consistently higher than normal and is most common in the hands, legs and feet. The condition is common – about 60% of people with diabetes have it – and it can have a serious impact on wounds and healing.
A big problem is that if you have diabetic neuropathy, you may not realize you have a cut, blister, ingrown toenail or callus because you can’t feel it. And if you have an early-stage diabetic blister or sore that doesn’t get the care that it needs, it may become infected or turn into a serious wound.
Weakened immune system
Some medical conditions can affect how well your immune system works. If you are living with diabetes, your immune system may not be able to get skin and wound infections under control.
High blood sugar can change the chemistry of your blood in ways that reduce your body’s defenses and makes your immune system work slower. Here are some ways that high blood sugar levels affect your immune system:
- Weakened defenses – Extra sugars in the blood break down into a compound called dicarbonyl, weakening your body’s defenses.
- Reduced natural immunity – High blood sugar causes more glycation, which is when a sugar molecule attaches to a protein molecule without the help of an enzyme. When this happens, parts of your blood don’t function how they should, reducing your body’s natural immunity.
- Healing delays – When blood is thick with high blood sugar, it takes longer for white blood cells to get to the wound site and fight off infection, delaying the healing process.
- Stronger bacteria – High blood sugar levels can make bacteria stronger so it’s even harder for a weakened immune system to fight off the invading bacteria.
How to tell if a diabetic wound isn’t healing properly
While people with diabetes often have slower-healing wounds, wounds should still look significantly better within a few weeks. The following are signs that your wound may not be healing properly and that you may need to talk to a doctor.
Inflammation that lasts too long or comes back
Inflammation is a normal part of the healing process. But after about a week, the redness and swelling around your wound should be gone. If it isn’t, something is getting in the way of the healing process.
Also, you should only see inflammation at the beginning of wound healing. If inflammation reappears later in the healing process, it may signal an infection or other problem.
Signs of infection or tissue damage
Diabetic sores and wounds can’t heal when they’re infected. So, talk to your doctor if your wound or the surrounding skin:
- Feels tender, painful or hot to the touch
- Oozes pus or liquid
- Is unusual in color or dark at the edges
- Smells badly
It’s been longer than four weeks
If wounds don’t heal within a month, they are considered chronic wounds. While it’s possible for chronic wounds to heal on their own, it’s best to get a doctor’s help to identify why the wound isn’t healing and provide treatment.
Tips to help a diabetic wound heal faster
There are steps you can take at home to make sure that little wounds don’t turn into big problems. An important one is watching your wound for signs of infection and inflammation. Here are some additional tips:
Find and treat cuts, scrapes and other wounds immediately
If you treat new wounds right away, you can start caring for them before things get bad. So as soon as you find a cut or sore:
- Wash your hands with soap and water.
- Rinse off the wound with warm water.
- Apply pressure to stop any bleeding.
- Apply antibiotic cream and cover with a bandage.
Of course, if you don’t know you have a wound, you can’t treat it quickly. So if you suffer from neuropathy, keep an eye out for new wounds. Check your hands and feet daily, and don’t forget to check between your toes.
Wearing white socks can help, too. If you see a red spot or a place where your sock is sticking to your skin, check your foot to see if you have a wound that’s new or not healing.
Take pressure off the area
If a wound continues to reopen or experience damage, it won’t heal quickly and may get much worse. So avoid putting stress, pressure and weight on wounds.
This can be tricky for some wounds like ones on your feet. If you need help, talk to your doctor about ways to protect your wounds while maintaining mobility. Special shoes and customized foot padding are common options.
Keep your wound clean and covered with the right dressings
Wounds heal best when they are clean and moist. So it’s important to get them clean and covered right away. If you have a new scrape or cut, a basic bandage and antibiotic cream should work just fine.
But if you have wounds that are infected, slow healing or more serious, make an appointment with a doctor to learn what the best wound care is for you. Your doctor will likely recommend different types of diabetic wound care dressings to protect the injury and promote healing.
Common types of dressings for diabetic wound care
- Foam dressings – Extremely soft and absorbent, foam dressings are used for wounds that leak or ooze a lot. They also offer added cushioning which can help protect the wound against physical damage.
- Alginate dressing – These types of dressings are primarily made from seaweed. They can hold up to twenty times their weight in moisture, making them a great choice for deep wounds and ones with discharge. Another advantage of alginate dressings is that they prevent the growth of new bacteria.
- Hydrogel dressings – Hydrogel is a water-based gel designed to keep an area moist. If your wound is dry or covered in dead skin, your doctor may recommend a hydrogel dressing to provide moisture. This can help break down dead tissue and promote cell growth. These types of dressings usually aren’t used for infected wounds.
What happens if diabetic sores or wounds are left untreated?
Wounds tend to heal more quickly with care and attention. But when you live with diabetes, everyday wounds are more likely to turn serious when they stick around for too long.
Diabetic foot ulcers or wounds
If foot wounds are left untreated, they may turn into foot ulcers, which are often called diabetic foot sores. In its earliest stages, a diabetic sore may look like a blister or burn. About 20-25% of people with diabetes will get a foot ulcer at some point in their life.
Here’s what causes diabetic foot ulcers
- The foot forms a callus.
- The callus receives ongoing damage. Most often, this happens when a person has neuropathy and can’t feel when their foot is hurt.
- Since the damaged callus isn’t treated when it should be, the skin erodes, leading to an ulcer.
Most foot ulcers are on the ball of your foot, often near your big toe. A foot ulcer looks like a red sore. You may have an early-stage foot ulcer if drainage from the sore is clear. If there’s colored pus and the wound smells badly, it may be infected.
If you have a foot ulcer, you should talk to your doctor about diabetic foot ulcer treatments. If it’s infected, you should make an appointment with your primary care doctor as soon as possible.
Foot ulcers can take a long time to heal – about three months – and you’ll need to check in frequently with a doctor to make sure that the healing process stays on track. In some cases, you may need special shoes to reduce pressure on the wound.
While this may all seem like a lot of work, there’s a reason to stick with it. If your foot ulcer doesn’t heal, it can turn into something more serious, possibly even the loss of a limb.
Gangrene occurs when body tissue dies – fortunately, this condition isn’t common. But it’s something to watch for, because it can cause serious issues if not caught and treated early.
Gangrene often begins with an infected wound. It usually starts in a certain area like a finger or toe, and then can spread over time. If the infection remains untreated for too long, the surrounding tissues can start to die.
Signs to watch for include:
- A reddish line around the wound, which becomes black
- Loss of sensation around the wound
- Skin that has turned an unusual color, such as red, blue, bronze or greenish-black
- Wounds that repeatedly reappear in the same place
If you think you have gangrene, you should get medical help right away. Your doctor will remove the affected tissue and repair the area, possibly with a skin graft. Infection will be treated with antibiotics.
If gangrene isn’t treated soon enough, the result can be amputation. The doctor may need to remove a finger or a toe to keep the gangrene from spreading – and if there’s a lot of dead tissue, they may need to remove an arm or leg. In some cases, gangrene can be fatal, so make sure to get treatment at the earliest sign of this condition.
Infected wounds can infect your bones, causing a condition called osteomyelitis. If bone infections aren’t treated, parts of your bones can die. Symptoms to look for include:
- Swelling and redness
- Skin that’s hot to the touch
- Pain or tenderness
- Yellowish pus coming through your skin
If you think you have a bone infection, make an appointment with your primary care doctor. There are effective treatments for osteomyelitis, but they work best when the infection is caught early.
How to prevent severe diabetic sores or wounds
Catching and treating wounds early is the most important thing you can do to prevent minor wounds from becoming more serious. But there are also things you can do to support your body’s healing processes – and even reduce your chance of getting wounds altogether.
Manage blood sugar
If you’re living with diabetes, you know that controlling blood sugar is key to many aspects of your health – and wound healing is no exception.
If your blood sugar is within the target range, bacteria won’t be as strong, and you may be able to fight off infections sooner. Plus, keeping your numbers in line can reduce your chance of getting certain conditions that affect wound healing, such as neuropathy, circulation problems and a weakened immune system. And if you have one of these conditions already, having good control of your blood sugar can help keep those conditions from getting worse.
Practice proper foot care
Foot ulcers are the most common type of severe diabetic wound. Through proper foot care, you may be able to avoid a foot ulcer. Here are some top tips:
- Keep feet clean, dry and moisturized – Wash your feet daily but don’t soak them. Once your feet are clean, carefully dry them, especially between your toes. Then apply a cream or an ointment such as petroleum jelly to your feet but skip between your toes. Moisture between the toes can lead to wounds.
- Make sure toenails are trimmed – Cut straight across and then file down sharp edges.
- Leave growth removal to your doctor – If you have a callus, bunion, wart or corn on your foot, don’t try to remove it on your own. Your doctor will know how to take care of it while helping to prevent infection.
- Choose socks with care – Wear white socks that are cotton or specifically designed to keep feet dry. They shouldn’t have tight bands or thick seams that can rub against your skin.
- Wear proper-fitting shoes – Choose closed-toe shoes with a wide toe box. Ill-fitting shoes can rub, causing sores and making wounds worse. Plus, bad shoes are a top cause of foot pain, so talk to a doctor or podiatrist if you can’t find a pair that works for you.
- Keep your feet covered – Don’t go barefoot, even indoors.
Up your protein intake and eat a healthy diet
A common diet recommendation for people living with diabetes is less carbohydrates and more protein. That’s because if you’re eating foods with less sugar and lower glycemic levels, it’s a lot easier to keep blood sugar levels in check.
Eating more protein has an added advantage – it can help wounds heal more quickly. If your diet doesn’t include enough protein, your body may take longer to build new tissue, and your wounds may be more likely to become inflamed or infected.
Also, make room for fruits and vegetables that contain vitamins A and C since these nutrients are vital to wound healing and may boost your immune system. Good foods to add to your shopping list include spinach, bell peppers, citrus fruits, broccoli, spinach, cherries and squash.
Don’t let the fear of getting a wound keep you from exercising. Keeping your body moving is an important part of managing your diabetes. Regular exercise improves how well your body uses insulin – so you can take less and have a better chance of keeping your blood sugar levels under control.
Plus, exercising can help improve wound healing in a couple of ways:
- Reduces inflammation, leading to quicker healing.
- Increases the antioxidants in your blood. Antioxidants protect your body against the unstable free radicals in your blood that can damage your cells and slow down healing.
Of course, you’ll want to take steps to make sure that your exercise program doesn’t lead to wounds and wound-healing issues. Watch out for new injuries and treat them right away. And if you have a wound that’s healing, avoid putting extra pressure on it. If you’re not sure how you can safely exercise, talk to your doctor.
If you have diabetes, smoking increases your chance of having complications that can lead to chronic diabetic wounds. There are a few reasons for this:
- Nicotine increases blood sugar levels, making it even more challenging to manage your diabetes.
- Your body is less effective at moving oxygen and blood.
- The chemicals in cigarettes increase inflammation.
- Smoking makes your immune system less effective.
If you currently smoke, quitting is one of the best things you can do to improve your overall health and your body’s ability to heal.
Get help for diabetic wounds that won’t heal
If it’s been more than four weeks and your diabetic wound won’t heal, we can help. We offer the most advanced therapies to help heal even the most severe wounds.