How Can a Diabetic Wound Heal Faster? 5 Strategies for Better Outcomes

A diabetic wound is a sore or ulcer that develops in people with diabetes and heals slowly or not at all. These wounds most commonly form on the feet but may form on the lower legs and, to a much lesser extent, on other parts of the body.

One of the unfortunate realities of diabetes is that it can result in diabetic peripheral neuropathy (DPN)—nerve damage caused by diabetes that causes pain and numbness and makes it difficult for the body to recover from injuries like diabetic wounds. One 2020 study on DPN notes the prevalence of this condition as high (40.3%) among diabetic patients.

Despite such a common complication, there are certain strategies that can aid in diabetic wound healing—ones that depend on both you as a dedicated practitioner and your patients. Below, we explore these strategies, along with the types, causes, and healing limitations of diabetic wounds.

Diabetic Wounds: Types, Causes, and Prevalence Factors

Types of Diabetic Wounds

Diabetic wounds can manifest in several ways, each with unique characteristics and underlying causes. Below are some of the primary types and their characteristics.

Neuropathic Ulcers

• Caused by: Loss of sensation in the feet due to neuropathy (nerve damage)
• Appearance: Often on the bottom of the feet, particularly under pressure points like the ball of the foot or the big toe joint, they can be deep and painless, often going unnoticed until they become infected
• Why they’re dangerous: Lack of pain signals can lead to delayed detection and worsening of the ulcer

Ischemic Ulcers

• Caused by: Poor blood flow to the affected area due to peripheral artery disease (narrowed or blocked arteries)
• Appearance: Typically occur on the toes or heels. They may appear as small, deep sores with surrounding skin that is cool to the touch and may have a bluish discoloration
• Why they’re dangerous: Inadequate blood supply hinders healing and increases the risk of infection and gangrene (tissue death)

Neuroischemic Ulcers

• Caused by: A combination of both neuropathy and poor circulation
• Appearance: Can present with characteristics of both neuropathic and ischemic ulcers, making diagnosis more challenging
• Why they’re dangerous: The presence of both nerve damage and poor blood flow significantly complicates healing and increases the risk of severe complications

Pressure Injuries

• Caused by: Prolonged pressure on the skin, often in individuals confined to a bed or those with diabetes
• Appearance: Can develop over bony prominences like the heels, hips, or elbows and may appear as red, discolored areas that can progress to open sores
• Why they’re dangerous: Can lead to deep tissue damage and infection, especially in individuals with limited mobility

Infected Wounds

• Caused by: Bacterial invasion of the wound
• Appearance: Signs of infection include redness, swelling, warmth, pus, and a foul odor
• Why they’re dangerous: Infections can spread rapidly, leading to serious complications like cellulitis, bone infections (osteomyelitis), and even sepsis

Causes of Diabetic Wounds

In general, diabetic wounds arise from a combination of causes that weaken the body’s ability to heal. Let’s look through the primary causes of each type.

• Neuropathy: High blood sugar levels over time can damage nerves, particularly in the feet. This leads to loss of sensation, making it difficult to feel injuries like cuts, blisters, or even small pebbles in the shoe. Unnoticed injuries can worsen, leading to open sores.
• Peripheral artery disease: Diabetes can damage blood vessels, reducing blood flow to the extremities, especially the feet. This deprives tissues of essential oxygen and nutrients needed for healing. Wounds in areas with poor circulation heal slowly and are more prone to infection.
• Weakened immune system: High blood sugar levels can impair the immune system’s ability to fight off infections. This makes people with diabetes more susceptible to infections in their wounds, which can significantly slow healing and worsen the condition.
• Foot deformities: Diabetes can lead to changes in the shape of the feet, such as hammertoes or bunions. These deformities can increase pressure on certain areas of the foot, making them more prone to injury and ulceration.
• Other factors:
  • Poorly fitting shoes can cause friction and pressure on the feet, increasing the risk of injury
  • Smokers with diabetes have a significantly higher risk of developing diabetic wounds
  • Consistently high blood sugar levels worsen the underlying conditions that contribute to diabetic wounds

Socioeconomic Factors Influencing the Prevalence of Diabetic Wounds

Though diabetic wounds may be directly caused by physical elements, oftentimes the prevalence of these wounds are influenced by a number of socioeconomic factors.

• Poverty and limited income:
  • Difficulty affording proper footwear increases the risk of foot injuries and pressure points, predisposing individuals to ulcers
  • Reduced access to nutritious food can contribute to poor blood sugar control and worsen underlying health conditions
  • Limited access to healthcare, like regular checkups, medications, and specialized foot care, can lead to delayed diagnosis and treatment of diabetic complications
• Lack of health insurance: Individuals without health insurance may delay seeking medical care due to the high cost of treatment. This can lead to the worsening of diabetic wounds and increase the risk of complications.
• Limited access to healthcare services: In rural or underserved areas, access to podiatrists, wound care specialists, and other healthcare professionals may be limited. This can delay diagnosis and treatment, increasing the risk of complications.
• Lack of education and health literacy: Limited understanding of diabetes and its complications can hinder individuals from recognizing the signs and symptoms of diabetic wounds. Difficulty accessing and understanding health information can make it challenging to manage diabetes effectively and prevent complications.
• Social isolation and lack of support: Social isolation can impact adherence to treatment plans, increase stress levels, and worsen diabetes control. Lack of support networks can make it difficult for individuals to manage their diabetes and access necessary care.
• Cultural and linguistic barriers: Language barriers and cultural differences can hinder communication with healthcare providers, leading to misunderstandings and delays in treatment.

How Can a Diabetic Wound Heal Faster?

Though diabetic wounds are notorious for healing slowly, strategies like the ones below are vital for accelerating the healing process.

These approaches not only promote faster tissue repair but also significantly reduce the risk of serious complications such as infection, amputation, and systemic infections, ultimately improving the overall health and quality of life for patients with diabetes.

1. Control Blood Sugar

Poor blood sugar management can impair immune function, reduce blood flow, and cause nerve damage. Educate patients on blood sugar control to help their diabetic wounds heal faster.

• Consistent monitoring: Regularly check blood sugar levels
• Medication adherence: Take prescribed medications for diabetes as directed, including insulin or oral medications
• Healthy diet: Follow a balanced diet rich in fruits, vegetables, whole grains, and lean protein while limiting processed foods, sugary drinks, and unhealthy fats
• Regular exercise: Engage in regular physical activity to improve insulin sensitivity and blood sugar control

2. Practice Proper Wound Care

One of the most clear-cut (no pun intended) ways  to speed up the healing of diabetic wounds is to ensure wounds are properly cleaned, dressed, and devoid of pressure (as much as possible).

• Wound cleaning: Gently wash the wound with mild soap and water. Pat the area dry with a clean towel. Avoid scrubbing or using harsh soaps, as this can irritate the skin.
• Proper dressing: Use appropriate wound dressings to keep the wound moist and protected from infection. Instruct patients on the best dressing options so they can change dressings properly and regularly at home.
• Pressure reduction: Use specialized footwear, such as diabetic shoes or inserts, to relieve pressure on the wound. Consider using cushions or padding to offload pressure while sitting or lying down. Avoid activities that put excessive pressure on the affected area.

3. Focus On Nutrition

Nutrients are the body’s fuel source, and many vitamins and minerals that patients absorb from food and supplement intake play a vital role in wound healing.

• Adequate protein intake: Protein is essential for tissue repair. Patients should include lean protein sources in their diet, such as fish, poultry, beans, lentils, and low-fat dairy products.
• Vitamin and mineral supplementation:
  • Vitamin C is important for collagen production, an essential factor in wound healing
  • Zinc plays a crucial role in cell growth and repair
  • Vitamin D helps regulate calcium levels and may also play a role in wound healing

4. Make Key Lifestyle Modifications

A patient’s lifestyle plays a significant part in diabetic wound healing. Encouraging them to reduce bad health habits and get their body moving can aid in the healing process.

• Smoking cessation: Smoking significantly reduces blood flow and impairs wound healing. Encourage patients to seek support from smoking cessation programs or consult with your clinic about nicotine replacement therapies.
• Regular exercise: Improved circulation is essential for delivering nutrients and oxygen to the wound. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
• Stress management: Chronic stress can negatively impact blood sugar control and weaken the immune system. Techniques like relaxation exercises, yoga, and meditation can help manage stress and promote overall health.

5. Try Advanced Therapies

While not suitable for every patient, advanced therapies can accelerate the healing of diabetic wounds, especially when standard treatments have been ineffective.

• Hyperbaric oxygen therapy (HBOT): Involves breathing pure oxygen in a pressurized chamber. This increases the amount of oxygen dissolved in the blood, which can improve blood flow to the wound and stimulate healing. HBOT can be beneficial for wounds with poor circulation or those that are not healing despite standard treatments.
• Negative pressure wound therapy (NPWT): Uses gentle suction to remove fluid from the wound bed, reduce swelling, and promote tissue growth. NPWT can accelerate healing, reduce the risk of infection, and improve wound closure.  
• Growth factor therapy: Growth factors are proteins that stimulate cell growth and repair. They can be applied directly to the wound to accelerate healing and reduce scarring.
• Platelet-rich plasma (PRP) therapy: Involves drawing a small amount of blood from the patient and processing it to concentrate platelets, which contain growth factors that can stimulate tissue regeneration. PRP uses a less targeted approach than growth factor therapy—making use of a broad spectrum of these proteins—and can be used to promote healing in chronic wounds that are not responding to other treatments.

Wound Care for Diabetic Foot Ulcers: A PRP Study A 2024 study on the efficacy of PRP in treating diabetic foot ulcers found a 63.7% success rate in using this advanced therapy. Conducted in Pakistan, the study included male and female patients aged 45–75 years with non-responsive diabetic foot ulcers. The primary outcome was treatment success, which the authors of the study defined as >90% healing after four weeks. There was no significant impact on treatment success based on age, gender, or disease duration. “This study reaffirms the efficacy of PRP in treating non-healing diabetic foot ulcers, aligning with previous research. Despite a slightly lower success rate compared to literature reports, PRP remains a promising agent for managing diabetic foot ulcers,” conclude the authors of the study.

Faster Diabetic Wound Healing Requires Focus and Teamwork

Diabetic wounds are a serious complication of diabetes, often caused by nerve damage, poor circulation, and infection. Effective wound management requires a multi-faceted approach, including strict blood sugar control, proper wound care, lifestyle modifications, and other strategies.

Early diagnosis, consistent monitoring, patient education, and a collaborative approach between the patient and your healthcare team are essential for optimal wound healing and preventing complications.