Abstract
All forms of diabetes mellitus are characterized by macro vascular and micro vascular complications. As a consequence of micro vascular pathology, diabetes is the leading cause of blindness, end stage renal disease and neuropathies. Patients with diabetes are at a high risk of myocardial infarction, lower limb amputations and stroke. Intracellular hyperglycemia causes abnormalities in the blood flow and increased vascular permeability. Changes in the extracellular matrix overproduction induced by the growth factors; leads to edema, ischemia and hypoxia induced revascularization in the retina; proteinuria, mesangial matrix expansion and glomerulosclerosis in the kidney and multifocal axonal degeneration in the peripheral nerves. There are four proposed mechanisms involved in the microvascular and macrovascular complications caused due to hyperglycemia. The prevalence of diabetes is rapidly increasing all over the world, India with the largest diabetic population. The so called “Asian Indian Phenotype” refers to unique clinical and biochemical abnormalities. This phenotype makes Asian Indians more prone to diabetes and premature coronary artery disease. Wound healing is a dynamic process that involves four continuous overlapping phases - Homeostasis; Inflammation; Proliferation and Remodeling. Interruptions, aberrancies or prolongation in this process can delay the process of wound healing or non- healing chronic wound. Multiple factors lead to impaired wound healing. They can be categorised as local and systemic factors. Local factors are those directly influence the wound itself. Whereas, systemic factors are the overall health or disease state and the ability of the individual to heal. In conclusion, wound care and prevention of non -healing chronic diabetic foot ulcers are treated with extracellular matrix replacement therapies; and wound care in diabetes plays an vital role.
