Diabetes, also called diabetes mellitus, is a condition in which the body can no longer produce, or can no longer use, insulin. The body requires insulin to turn sugar into energy, but if it no longer makes insulin or can no longer use it, the sugar builds up in the bloodstream. This sugar accumulation in the blood can lead to severe health consequences.
About a third of the people who have diabetes do not know they have it. Sometimes the disease can be present without any outward symptoms. It is important to have regular check-ups with your doctor so that he or she can screen you for diabetes.
Some diabetics present with symptoms, however. If you experience any of the following on a persistent basis, consult your family physician.
- Increased hunger
- Increased thirst
- Dry mouth
- Frequent urination
- Frequent urinary tract infections
- Blurred vision
- Itching, especially in the groin area
- Numbness and tingling in the hands and feet
- Dark skin changes in the neck, armpit and groin, called acanthosis nigricans
In addition to the above, diabetics can have a compromised ability to heal.
Most of us suffer numerous cuts and other small wounds throughout our lives. For a diabetic, they can turn into something far more serious. Diabetes wound healing can be very slow, and more likely to become infected. If the infection becomes septic, meaning that it gets into the bloodstream and spreads throughout the body, the results can be fatal.
Diabetics need to check their bodies very carefully for even minor scrapes, especially their extremities, with particular attention to the feet. About 15% of diabetics suffer from foot ulcers and other diabetic wounds that are hard to heal. Diabetic wound care is important for preventing this.
Diabetes affects wound healing in a variety of ways:
- High blood sugar. This is the main reason why a diabetic’s wounds heal slowly. High sugar levels in the blood prevent nutrients and oxygen from giving cells energy and increase inflammation in the cells.
- Neuropathy. High sugar levels can damage nerve cells over time. After a while, diabetics can lose sensation in their extremities. When this happens, they can develop a wound and may not realize it.
- Bad blood flow. Diabetes can reduce the blood flow, especially to the body’s periphery, in three ways. First, high glucose levels make it harder for red blood cells to pass through blood vessels. Second, sugar thickens the blood. Third, it can narrow the blood vessels.
- Immune system deficiency. With diabetes, the body often sends a reduced number of cells to heal wounds. This will naturally slow the healing process.
- Infection. With the immune system compromised, the body cannot fight off infections as it could before. In addition to this, bacteria can thrive on the high levels of sugar in the blood. More bacteria and reduced defensive capability lead to a greater chance of infection.
Compounding Diabetic Medications
Diabetes medications can extend and improve the quality of life for those who suffer from the condition. One of the challenges is requiring the patient to take several types of medication on a daily basis. Remembering when to take which medicine, how much and at what time can often be challenging for patients.
A pharmacist can compound the medications or mix them together in a prescription specially designed for the patient. Diabetic patients can then control their symptoms and reduce the chance for errors with the use of compound medications.
Currently, there are many medicines available that aid in wound healing. By combining them, a diabetic can get the same result with a far simpler process. Some of the commonly used medicines for wound healing are:
- Phenytoin. Promotes tissue formation in the wound.
- Misoprostol. Accelerates wound healing.
- Metronidazole. An antimicrobial agent.
- Nifedipine. Increases passage of blood to tissues and organs.
- Lidocaine. This drug reduces pain and increases blood flow.
- Tea tree oil. An anti-fungal, anti-bacterial, and anti-inflammatory agent.
- Pentoxifylline. Improves blood viscosity.
Rather than apply these substances individually, a patient can apply them all at once by taking advantage of medication compounding. This promotes a comprehensive healing effect with the application of just one medication. The benefits of doing this are many.
Debridement is the removal of dead tissue from a wound, which allows the wound to begin to heal. There are several kinds of debridement, including surgical, autolytic, mechanical and biological. There is also chemical debridement, which is the application of a chemical to the wound to remove dead tissue.
With the compounding of medications, a pharmacist can strengthen the effect of the debridement. For instance, he or she can mix collagenase and urea to increase the loosening and break up of necrotic tissue. It is also possible to increase the strength of collagenase, when used alone, through the process of compounding medications.
Increasing Vascular Perfusion
The more efficiently blood can flow to a wound, the faster it will heal. Diabetics often have decreased blood flow, but there are topical medications that can alleviate the problem.
A pharmacist could use nifedipine, which increases vascular perfusion, with lidocaine, an anesthetic that also promotes blood flow. He or she may then add pentoxifylline, which improves blood viscosity. All this can create a single, powerful medication.
Collagen is the main structural protein in the body’s connective tissues. It can provide a scaffold onto which other cells affix themselves to begin the healing process. With medication compounding, the collagen can be supplied through a topical ointment or cream.
Reducing Pain And Inflammation
Local anesthetics can deaden pain and make manipulation of the wound a less difficult experience for patients. Many of these same medications also promote blood flow, and they can all work together when pharmacists use compound medications.
A wound’s bioburden is the metabolic load that bacteria impose on it. Compound medications can carry antiseptics, antibiotics, and antifungals to prevent microbes from interfering with the healing process.
When a person becomes diabetic, the high sugar in their blood can start a cascade of problems affecting their body.
Compounding pharmacists can combine medications to achieve multiple effects at once, as well as to enhance the effects of individual medicines when they work in conjunction with a similar medication. In this way, compound medications have become an important tool for dealing with hard-to-heal wounds.