Sunday, December 4, 2011

Does good sugar control help healing?

If you have diabetes, there are many good reasons to control your blood sugar.   
And what about healing?

Does good sugar control help healing?
How about vice versa?
If you heal well, does that mean your sugar is under good control?

Let’s tackle the first question, first. Does good sugar control help healing?
Is there good evidence that better blood glucose control means a better chance of healing of wounds, skin sores or infections?

Many doctors believe that skin wounds or soft tissue ulcers on the arms, legs or feet might heal better with better blood sugar control. But it may surprise you to learn that there is no solid evidence that better sugar control translates into a better chance of healing. Getting blood glucose close to normal might help healing and certainly shouldn’t hurt healing but there just are no high quality studies that I could find to prove the benefits of blood sugar control on healing.

It is clear that certain infections are much more likely to occur when blood sugars are uncontrolled. For example, vaginal yeast infections, called vaginal candidiasis are much more likely when blood sugars are high. In fact, some women discover they have diabetes when they just can’t seem to get rid of their vaginal yeast infection and their doctor thinks to check the urine for sugar or to check the blood sugar level.

And men can get yeast infections on their penis when their sugars are running especially high.

But when it comes to skin cuts, wounds or ulcers on the feet, legs and arms, blood sugar control has not yet been proven to be important for healing.  
On the other hand, some doctors who run wound care centers think blood sugar control really makes a difference. They see non-healing foot ulcers suddenly heal when the blood sugar is controlled. 
Despite these doctor's stories, that we call anecdotes, the proof is not there that good sugar control helps healing.

So now I bet you can answer the other question I asked.
If my cuts and sores heal quickly, does that mean my sugar is well controlled?

The answer is absolutely not!

You can have poor control of your diabetes and still heal okay.
I have certainly seen this among my patients.

You need to test your sugar and have testing of Hemoglobin A1c (abbreviated HgbA1c) in order to tell if your diabetes is under good control.

Remember, there are many reasons to keep those sugars controlled. Like protecting your eyes, kidneys and nerves from damage. And when there’s nerve damage, over time, there’s an increased risk of foot problems, even amputations.

Until further studies are done, prevention is key. 
Keep your glucose well controlled and take good care of your feet.

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