Wounds Healing in Diabetis patients

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ABSTRACT

Wound healing is a complex process, as is the pathophysiology that leads to impaired wound healing in patients with diabetes mellitus. Diabetes mellitus is a metabolic disease in which elevated blood glucose level leads to glycemic-induced pathology. The rate of wound healing in patients with diabetes is significantly slower than that of non-diabetic patients. A combination of medical and surgical therapy is used to improve wound healing in patients with DM. The main purpose of this research study is to discuss how diabetes impairs wound healing.

TABLE OF CONTENTS

ABSTRACTII

CHAPTER 1: INTRODUCTION1

Research Background1

Research Aims and Objectives2

Structure of the thesis2

CHAPTER 2: LITERATURE REVIEW4

Impaired Wound Healing in Patients with Diabetes Mellitus4

Wound Healing in Diabetes Mellitus5

Keratinocyte Dysfunction5

Fibroblast Dysfunction6

Macrophage Dysfunction7

Current Therapy Regarding Wound Healing in Diabetes Mellitus7

CHAPTER 3: METHODOLOGY9

Research Design9

Ethical Considerations10

REFERENCES11

CHAPTER 1: INTRODUCTION

The purpose of this chapter is to provide the reader a brief overview about the research topic and provides the main purpose and aim behind this research study. It comprises of the background of the problem, which provides a brief overview of the topic of the research and the problem.

Research Background

Diabetes mellitus is a metabolic disease in which elevated blood glucose level leads to glycemic-induced pathology. A patient with new onset DM may present clinically with lethargy, polydipsia and polyuria (Lan et al. 2008). To confirm the diagnosis of DM, laboratory tests are performed to measure the level of blood glucose on two separate days. The current standard guidelines used for the diagnosis of diabetes are as follows: a fasting elevated blood glucose level greater than or equal to 126 mg/dL, or a random non-fasting blood glucose level greater than or equal to 200 mg/dL, or a 2 hour plasma glucose level greater than or equal to 200 mg/dL during a glucose tolerance test (Lan et al. 2008).

Insulin therapy is the primary treatment for T1 DM patients. Ideally, a patient should maintain his or her blood glucose level within a narrow range. The overall therapeutic goal in T1 DM is to maintain a pre-prandial glucose level of 90-130 mg/dL and a peak postprandial glucose level of less than 180 mg/dL (Lan et al. 2008). Glycosylated hemoglobin, hemoglobin A1C (HgbA1C), is measured to determine the average blood glucose level over a three month period. The goal of a patient with DM is to maintain his or her HgbA1C at less than 7%. An HgbA1C of 7% correlates with an average blood glucose level of 172 mg/dL (Lan et al. 2008). There are several different insulin preparations available to treat hyperglycemia. They can be classified into two main categories, short acting which last 3-6 hours and long acting which last 10-24 hours. Short-acting insulin is used to mimic physiologic insulin release after meals; long-acting insulin is used to mimic the basal insulin physiologic levels between meals (Lan et al. 2008).

Research Aims and Objectives

The primary purpose of this study is to discuss how diabetes impairs wound healing. In order to achieve this aim, the researcher has divided the aim in a few ...