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Resource: Surgery with Diabetes at UPMC in Central Pa.

Diabetes is a condition where the body is unable to control blood sugar levels either due to lack of insulin (Type 1) or resistance to insulin (Type 2). In diabetics, wounds heal more slowly and can worsen more quickly. This is due in part to poor circulation, diabetic neuropathy and immune system deficiency as a result of elevated blood sugars.

Hyperglycemic (elevated blood sugars) can stiffen the arteries and increase rigidity of the cell walls which makes the blood vessels narrower. As a result, blood flow is reduced which then limits the movement of red blood cells that carry oxygen and nutrients to the wound. Without oxygen, the immune system is comprised. The movement of white blood cells, which fight infection, and the growth of new tissue is limited.

Nerve damage with loss of sensation can occur with elevated blood sugars. This loss of feeling means that diabetic patients are not always aware of the development of infections, which can lead to delayed treatment and increased complications.

Tight control of blood sugars is paramount to the healing process.

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