Studies have associated diabetes with other complications- particularly, wound healing. In fact, delayed healing of wounds is an indication that the person might be suffering from diabetes. Even minor wounds should not be ignored, and all problems associated with skin should be taken seriously. ‘...diabetes affects all facets of wound healing and wound management. ...Wound healing is more difficult with older people with diabetes. Treat the cause and take a multidisciplinary approach...wounds must be regularly evaluated and documented with defined goals of treatment.’ (Dunning 2005, p.177) Having defined goals mean that the progress of given treatment should be monitored on regular basis. Obesity can lead to cardiovascular diseases and diabetes mellitus as evident from research. The relationship between adipose tissue and diabetes can greatly help in understanding their effects on wound healing. The classical perception of adipose tissue as a storage place of fatty acids has been replaced over the last years by the notion that adipose tissue has a central role in lipid and glucose metabolism and produces a large number of hormones and cytokines, e.g. tumour necrosis factor-α, interleukin-6, adiponectin, leptin, and plasminogen activator inhibitor-1. The increased prevalence of excessive visceral obesity and obesity-related cardiovascular risk factors is closely associated with the rising incidence of cardiovascular diseases and type 2 diabetes mellitus. (European Heart Journal 2008, pp. 2959-2971) Malnutrition has also been found to play important roles in triggering diabetes. Insulin deficiency is sometimes related to malnutrition. ‘The precise mechanism of abnormal wound strength in diabetes remains to be studied further, but careful control of diabetes, maintenance of nutrition, and treatment of systemic illness are important factors in the promotion of wound healing.” (Yue et al. 1987, pp. 295-299)
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