One of the hallmarks of diabetes is poor circulation. High blood sugar levels can cause damage to your blood vessels and can prevent a cut or open wound from healing properly. Poor circulation means that someone with diabetes can quickly develop a foot ulcer – a situation that can escalate into gangrene and the need to amputate the extremity if wound care doesn’t resolve the foot ulcer. Treatment is often not effective, so it’s good news that researchers are looking to develop quick and effective ways to treat and heal foot ulcers in people with diabetes. In fact, diabetes foot ulcers are the most common foot injuries that lead to foot amputations.
On average, once a foot ulcer develops, it can take around to 130 days to completely heal. Efforts to improve or speed up healing time could dramatically improve a person’s quality of life and likely allow for a better outcome. The researchers experimented with human cells to try to find a way to harness the body’s own healing mechanism, amplifying levels of nitric oxide. Nitric acid levels are often impaired in patients with diabetes. In this case, utilizing bandages containing nitric oxide that release levels as needed to the damaged cells seems to have solved this challenging medical treatment issue. The 2018 study published in MDPI-Medical Sciences showed that when nitric oxide is introduced and monitored closely, it is speculated that if the release of nitric oxide at different stages of the ulcer could be regulated in patients, wound healing would be shorter and smoother.
The research team plans to collaborate with a health system, in order to have access to more human cell samples. This next phase would allow them to test personalized bandages laden with specific amounts of nitric oxide, since there’s some variability of nitric oxide. They can then create bandages that hold the amounts of nitric oxide that will match and compensate for the levels needed by an individual patient. They anticipate having bandage prototypes in a few years. The nitric oxide-releasing bandage could be a game-changer in the diabetes world, lowering rates of amputations and ensuring better quality of life for individuals with diabetes.
Another 2018 study out of the UK used a special type of bandage on 148 people with diabetic foot ulcers. These bandages used technology that absorbed excess fluid while promoting a cushioned and moist healing environment and the production of higher levels of nitric acid. Outcomes included a higher rate of healed to completion foot ulcers and fewer hospitalizations associated with foot ulcer complications. Although the results are promising, nitric oxide bandages are not yet recommended by the American Diabetes Association (ADA). More research is needed before any new treatment can become the new standard of care.
A cornerstone of diabetes is to prevent foot trauma and open wounds, in order to limit risk of a foot ulcer. Tips to do that include:
- Use protective footwear like wool socks that are breathable, indoors and outdoors (indoors with rubber treads to prevent slipping).
- Have a family member or friend help you to examine your feet regularly since diabetes-related nerve damage can result in skin numbness which may hinder your detection of a small abrasion or cut
- Keep feet clean and dry
- Have a health professional trim your toenails
- Make sure you have your shoes measured to avoid shoes that are too tight or too loose
- Check inside your shoes regularly to make sure they are not breaking down and developing sharp edges or seams
- See a podiatrist regularly
- If you do develop a wound or cut, seek medical attention immediately and comply with all wound care instructions
- Closely monitor and manage blood sugar levels
See more helpful articles:
Hyperbaric Oxygen Therapy for Wound Care
FDA Approves Treatment for Diabetic Foot Ulcers
Speeding Up Wound Healing with Debridement