Managing Diabetes Promotes Healthy Wound Healing
By Nancy Kennedy
The body’s amazing capacity for healing enables human beings to recover from injuries and wounds to the skin, tissues, and organs. This natural biological process cleans, repairs, protects, and restores wholeness to damaged tissue, enabled by medical science and technology. Wound healing does not always go perfectly, however, and can be slowed or interrupted by multiple factors such as malnutrition, infection, co-existing medical conditions, age, smoking, and others.
A slow healing wound, or non-healing wound, is a complex clinical problem that affects people with a variety of diagnoses and medical conditions. Persons with diabetes are the most frequently affected, but post-operative patients with surgical incisions, those with chronic venous insufficiency, and people who have pressure ulcers can also experience the significant adversity of an unhealed wound. Such wounds can result in pain, restricted mobility, infection, depression, and even social isolation; at worst, they may lead to the loss of a toe or lower limb. The management of slow wound healing requires the expertise of a team of specialists, including podiatrists, endocrinologists, plastic surgeons, vascular surgeons, wound healing nurse specialists, and dietitians.
At St. Clair Health, one of those specialists is Allison Caparoula, MS, RD, CDCES (Certified Diabetes Care and Education Specialist) - credentials that reflect her extensive experience and expertise. At the St. Clair Hospital Diabetes Center, her role is to educate and guide patients to understand and manage their disease with competence and confidence. Patient education, she says, is essential to good outcomes. “When you learn good self-care behaviors, and you know how to manage your diabetes well, you minimize the risk of short- and long-term complications such as wounds that will not heal.”
Diabetes is a complex disease, Caparoula explains, and patients need a lot of support. For her, high quality care means meeting with patients one-on-one, giving them individual attention and tailoring the education to them. “So much is at stake,” she says. “What appears to be a simple wound can develop into a serious complication. People with diabetes are at high risk for unhealed wounds for two reasons: they have loss of feeling and sensation in their lower legs and feet, and they may have poor blood flow.”
She continues, “But wounds can be prevented or minimized with good self-care: foot care, good nutrition, exercise, and glycemic management. Foot care means that people with diabetes need to examine their own feet every day to check for sores or cuts. They should use a mirror to look thoroughly. If you see an ulcer or sore developing, don’t try to self-treat it. See your doctor. In addition, we recommend an annual exam by a podiatrist or your PCP.”
Glycemic management is a process of controlling blood glucose levels to stay within a target range; this reduces the risk of complications including neuropathy and wounds. “Glycemic management is complex, and not all the factors are within the person’s control. But they can practice lifestyle modifications, close monitoring of glucose levels, and medications,” Caparoula says. “Exercise and well balanced meals, possibly with higher calories and protein, plus the use of a glucometer and tracking your A1C, are all part of glycemic management. Tight glucose control is essential to prevent short and long term complications.”
Exercise has numerous benefits for people with diabetes, according to Caparoula. “Exercise is great for preventing neuropathy and stabilizing the blood sugar. It helps the body fight insulin resistance.”
“It can be hard to manage diabetes, but you don’t have to do it alone,” says Caparoula. “Find a Certified Diabetes Care and Education Specialist to help you. We are available to be the support for you. If I can make it a little easier for someone to self-manage their diabetes, I am happy to do that.”
Approximately 29 million Americans have diabetes, and Western Pennsylvania has one of the highest rates of diabetes in the country. If you are living with diabetes and would like support managing the condition, visit stclair.org/diabetescenter or call (412) 942-2151 for more information about the St. Clair Hospital Diabetes Center.