How does diabetes mellitus impair wound healing?
A. Local hypoxemia, reduced angiogenesis, and inflammation due to vascular diseaseUncontrolled diabetes results in reduced inflammation, angiogenesis, and collagen synthesis. Additionally, the large and small vessel disease that is the hallmark of advanced diabetes contributes to local hypoxemia. Defects in granulocyte function, capillary ingrowth, and fibroblast proliferation all have been described in diabetes. Obesity, insulin resistance, hyperglycemia, and diabetic renal failure contribute significantly and independently to the impaired wound healing observed in diabetics.