Wound healing in T1D is a somewhat controversial topic. Many believe that people with T1D are automatic poor wound healers. But, that’s not actually the case.
Yes, diabetes does have an increased risk for wound healing implications, but that risk is not a guarantee.
This post is all about the dynamics and assumptions of wound healing in T1D, what implicates wound healing, what promotes it, and those times beyond T1D that we need to listen to our own gut instincts.
The long road of injury
My right foot has plagued me for a full year now.
It feels like plantar fasciitis, but on the top of the foot, not the bottom.
As soon as I felt the pain, I started going to physio, a podiatrist, and my family doctor.
I had shock wave therapy, heat and ice therapy, cupping on my calves, and massage therapy. I refused IMS because I’ve never had good results with it, and the thought of IMS in my foot was too much.
I worked on various strengthening exercises.
Nothing took.
One physio fired me. He told me, you’re not getting better, I’ve got nothing left here for you. Another physio blamed my diabetes.
NOOOOOOO!!!
Diabetes does not mean poor wound healing
Just because we have diabetes does not automatically mean we heal poorly.
Poor wound healing comes when blood sugars are more erratic and in a prolonged state of hyperglycemia. Not just because we have T1D!
When blood sugars are chronically high, it can cause problems with circulation, nerves, and the immune response – all of which can challenge wound healing.
If there’s too much sugar in the blood it creates a state of thick sludge, impairing blood flow and circulation.
Other potential issues for poor wound healing with diabetes include:
- Peripheral vascular disease. This reduces blood flow to arms and legs due to plaque buildup in the arteries
- Neuropathy, which is a loss of feeling that can impair a person’s ability to recognize when wounds or infections are present
- A weakened immune system that reduces the body’s ability to defend against injury
These are all potentials, but they are not guarantees. Again, just because we have diabetes does not automatically mean we are going to be poor wound healers. The state of our T1D may be a factor, but not the fact that we have T1D.
Wound is the cause, not the diabetes
Wound is the cause, not the diabetesA few months after the pain started, I approached my family doctor and requested an ultrasound, but they opted to do an x-ray instead. I challenged that direction, knowing from past experience that an x-ray would likely not reveal much in the way of foot injury. But the doctor was headstrong in their decision. Sure enough, the x-ray revealed nothing.
After about 10 months suffering from the foot pain, I finally had two ultrasounds completed on my whole foot and ankle.
The ultrasound showed a tear in the deltoid ligament of my ankle, a tear in the plantar plate of my foot, which is a ligament in the ball of the foot, bursitis in the 3rd and 4th metatarsals (between the toes) and possibly neuroma in those areas as well.
The cause: trauma to the top of the foot.
On the day the injury occurred, I had been wearing a replacement pair of Vans. The laces were tied too tight for far too long, and with my super poppy veins and ligaments it created a domino effect of injury.
The podiatrist who ordered the ultrasound and explained the results told me that these injuries are notorious for long recovery – nothing to do with the state of my diabetes.
In summary
Friends, trust your instincts. When that one physio told me that it was likely not healing because of my diabetes, right away, I said no. When my parent’s friends told me it was likely diabetic neuropathy, I said no – and subsequently had my endocrinologist confirm the same.
Just because we have diabetes does not mean we are guaranteed for all of its potential baggage.
And just because a person works in healthcare does not mean they are experts in T1D care.