Treatment of Type2 Diabetes

A New Way to Heal Diabetic Wounds

It’s been estimated that someone loses a limb to diabetes every 30 seconds. Often, a minor wound can eventually lead to an amputation—although for those with diabetes, there’s really no such thing as a “minor wound”. At the first sign of a diabetic wound, it’s important to battle any contaminating bacteria, get rid of any dead tissue, and maintain a clean, moist environment.

The problem is that the current standard of care for dressing wounds—especially the non-healing wounds that are all too common among people with diabetes—is inadequate. Traditional absorbent dressings are made of foam, which just holds the material to be absorbed in place and keeps the wound soggy. This can break down the healthy tissue around the wound. There are also wound-healing gels that may provide too much moisture to the wound. Other dressings often leave residue behind.

A new strategy to wound care is regenerative medicine. The regenerative approach gives non-healing wounds the protein “building blocks” needed to start rebuilding healthy tissue. Regenerative healing also cuts down on non-productive inflammation, which prolongs the vicious cycle of stalled wound healing. When you cut down on inflammation and provide needed proteins, you end up with a healed wound that has minimal scarring, as well as much softer and more functional tissue.

One identified source for these “building blocks” is the placenta of a normal, full-term pregnancy. In carefully screened volunteer donors, the placenta is recovered after birth. The various layers of the placental membrane are then separated to find the amniotic membrane, which is used in wound healing. This amniotic membrane is stripped of its cells, processed, slowly dried to a dehydrated state, and cut into thin sheets.

Once placed on a diabetic wound, the membrane may look like a simple piece of tissue paper—but inside, it’s a powerhouse. Researchers believe it can help your body wake up dormant cells in the skin, and gives those cells a basement structure on which to build new layers of healthy skin. Better still, it offers a biological barrier to infection and fluid loss, and minimizes pain upon application.

Researchers have demonstrated dramatic wound closure rates for chronic wounds, while recent studies of the mechanisms involved are offering a better understanding of the healing process. There are anecdotal success stories being shared – a Connecticut patient with diabetes recently told a NBC news reporter that after his chronic foot wounds were treated with amniotic membrane, he could wear regular shoes again. While it is still a new treatment option with a short track record, amniotic membrane could represent the next stage of advanced wound care for chronic, non-healing wounds in diabetes patients.

The author is employed by a wound care product company; Insulin Nation received no compensation for this article.

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Janice M. Smiell, M.D. is Chief Medical Officer at Alliqua BioMedical Inc., a provider of advanced wound care products.

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