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Wound healing and how diabetes affects it

Polina Ivanova, Tsvetan Popov, Evelina Zlatanova


Introduction: Wound healing is a complex and dynamic process of replacing devitalized and miss­ing cellular structures and tissue layers in the human body. Healing is achieved through four conse­quent phases: haemostasis, inflammation, proliferative and remodelling of tissue. Many factors can interfere with these stages, causing impaired or delayed restoration of wounded areas. Some items that impede the healing process include malnutrition, stress, obesity, medication intake, alcoholism, smoking and conditions such as diabetes mellitus. Several key factors influence wound healing in pa­tients with diabetes - blood glucose levels, blood circulation, neuropathy and immune system defi­ciencies. This paper aims to consolidate, analyse and review the significance of the diabetic condition in patients and its effects on the wound healing processes in the body.

Materials and methods: A thorough survey of the literary on the issue, how certain stages and types of diabetes disturb cell restoration and wound healing, was conducted using compiled data, gathered from articles published in PubMed. The effect of decreased oxygenation, glucose and insulin levels in diabetic patients has also been investigated.

Results: The number of people affected by diabetes has nearly quadrupled since the 1980s, with prev­alence of the condition rapidly increasing worldwide. While diabetes can lead to complications in many areas of human body, one major consequence is impaired and slowed wound healing and thus increased incidence of wound complications in surgical patients with diabetes mellitus.

Conclusion: Wound healing is a consequentially programmed biological process with many factors of influence. Diabetes with all its impacts and complications can play major role in all phases of the cell restoration cycle, contributing to the overall effectiveness and outcome of the healing pro­cess. Wounds in diabetic patients result in high morbidity, prolonged hospitalization, and heightened health-care expenses.


diabetes; wound healing; decreased oxygenation; glucose; insulin



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