ELI5. Why does recovery from an injury or cut, takes longer time for a person with high blood sugar than a normal person
In: 69
I’m not sure it’s solely the fact that someone has high blood sugar leading to impairment of wound healing, but it does contribute. Diabetics have increased blood sugar for one of two reasons. 1) autoimmune destruction of cells in the pancreas responsible for insulin production (type 1 diabetic), or 2) insulin resistance in tissues (type 2 diabetics). As a net result of inefficient insulin use in the body regardless of type, blood sugars run high in addition to numerous other abnormal physiologic changes in a diabetics body that render them immunocompromised by definition. Wound healing involves numerous mechanisms that are not functioning as efficiently in someone with diabetes as a result. Some of these mechanisms include but are not limited to:
-decreased or impaired growth factor production
-the specific angiogenic response (that is – the ability of new blood vessels to form from preexisting vessels in the area)
-macrophage function (a cell that sends chemical signals for wound healing among other important functions)
-collagen accumulation (new tissue being laid down)
-the degree of neuropathy (issues with signal transduction) and vasculopathy (disease of arteries and veins that can lead to abnormal blood blow to specific areas)
-This is important because bleeding is healing…
There are plenty of other potential mechanisms.
So to answer your question in one line: it’s not as simple as just having high blood sugar that leads to impaired wound healing.
Sources: I’m in PA school and UpToDate
Hope this helps 🙂
People suffering from diabetes and chronic high blood sugar are prone to nerve damage.
Sugars form crystals which damage the nerves particularly in the hands and feet.
Not only does this create a loss of sensation, but it can cause extensive pain, and interrupts the bodies healing process making it much more difficult for them to heal and fight off infections.
This is one of the principal reasons that people with severe diabetes often end up with amputations, and severe infections is one of the leading causes of death for diabetics
Non-enzymatic glycosylation from high concentrations of circulating blood glucose causes microvascular damage (tissue level), damage to normal cells and their extracellular matrices (cellular level), and causes up-regulation of inflammatory protein synthesis making it more difficult to recruit cells to maintain the healing process (molecular level). These all contribute to poor wound healing in diabetics.
5yo version:
In people with diabetes, the amount of sugar in their blood is much higher than in someone without diabetes. This extra sugar is more than their body can handle, so it sticks to the cells all by itself. Once this happens, the cells don’t work as well as they should, and it makes it a lot harder for those cells to ask for help from other cells to heal.
Source: MD
People with diabetes have impaired blood flow to their skin, particularly their extremities. High blood sugar is known to cause vascular and microvascular damage, so when there’s a cut the body can’t provide blood flow as effectively to heal the area.
Keep in mind, this is mostly true for people with type 2 diabetes and poorly managed type 1 diabetics. Well managed type 1 diabetics generally won’t have any problems worse than your average person, since their blood glucose levels tend not to be much different.
As a diabetic, let me take this one:
We’ve all seen sugar crystals. They are sharp edged cubes. Even when the sugar is in your bloodstream, it’s still basically a sharp edged cube. Sugar crystals hitch rides on red blood cells, which look like the inner tubes you find on the Lazy River at water parks.
Normally, there’s just a few of these sharp crystals on each red blood cell. But when you have high blood sugar, there are many more of them. And when the red blood cells get out of your arteries, and into the tiny little capillaries that service your actual skin and muscle, those sugar crystals are now bumping up against the sides of the capillaries. The sharp edges work like scouring pads, tearing up the capillary walls and preventing nutrients from getting to where they need to go. That’s why so many diabetics like me end up with poor sensation in their feet and fingers.
Sugar is a bunch of tiny crystals. Sharp. This means they can be pretty scratchy. Too much of it can actually scratch up your arteries and veins a bit
This is what people mean when they say sugar is “inflammatory”; Your veins swell up a little bit in response to the irritation; Think like a bruise.
This swelling of the veins can cause poor blood flow because the squeeze is tighter, which slows the delivery of nutrients that would help exterior wounds.
Ontop of that, sugar is shaped similarly enough to vitamin C, that your white blood cells can actually mistake sugar for it. As a result, some of your white blood cells will actually not get any vitamin C.
Since vitamin C helps your cells with fighting infections (pathogens), and sugar doesn’t, it can slow things down even more
the circulatory system is like any mechanical system. The more work it does the more it needs maintenance, The body does this and the more things it is working on repairing at the same time the more time it takes to repair each one. High blood pressure stresses the circulatory system and wears it down over time thus needing more repairs than a circulatory system working under normal pressure. There are more complicated reasons for this but this is one that is easiest to explain in simple terms. Now go read a dictionary.
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