1) "Patients with diabetes often have wounds that are difficult to heal. The initial barrier to healing is an increased blood glucose level, which causes the cell walls to become rigid, impairing blood flow through the critical small vessels at the wound surface and impeding red blood cell permeability and flow. Impaired hemoglobin release of oxygen results in oxygen and nutrient deficits in the wound.3 A less-than-optimal immune function also contributes to poor wound healing in the patient with diabetes. When blood glucose levels arc persistently elevated, chemotaxis and phagocytosis arc compromised.4 Chemotaxis is the process by which white cells are attracted to the site of an infection; phagocytosis is the ingestion of bacteria by white cells. Both processes are important in controlling wound infections. Diabetic infections take longer to heal because of delayed macrophage introduction and diminished leukocyte migration, which causes a prolonged inflammatory phase in the wound healing cascaded Protein-calorie malnutrition and the resultant body composition changes are an additional consideration in wound healing. Patients with diabetes often have a progressive loss of lean body mass, which is replaced with a metabolically inactive fat mass." Source and further information: http://findarticles.com/p/articles/mi_qa3977/is_200311/ai_n9342483 2) "Proper wound healing can be a problem for diabetic patients. The increased glucose level in individuals with diabetes causes cell walls to become rigid, which impairs blood flow through the small vessels at the wound surface, impeding red blood cell permeability and flow, states Nancy Collins in a 2003 article. What’s more, this chain of events leads to impaired hemoglobin release of oxygen and nutrient deficits in the wound [Collins, 2003]. Decreased immune function also contributes to poor wound healing in patients with diabetes. When blood glucose levels are persistently elevated, chemotaxis (the process when additional white cells move to the site of an infection) and phagocytosis (the ingestion of bacteria by white cells) are compromised [Collins]. Both of these processes are key to controlling wound infections. According to Collins, diabetic infections also take longer to heal because of delayed macrophage introduction and diminished leukocyte migration, which cause a prolonged inflammatory phase in the wound healing cascade." Source and further information: http://www.nationalhealing.com/downloads/nhcwhpspring07FIN.pdf