Living with type 2 diabetes is an ongoing struggle to keep blood sugar levels in check so the body can protect itself properly. With time, self-defense mechanisms break down, leaving patients at risk for serious damage to their eyes, kidneys and extremities. In the arms and feet, for example, nerve endings often become damaged and cause neuropathy, which is a condition that makes it difficult or impossible to feel pain, cold or heat.

“When most of us get a foot injury, we know it right away. But someone suffering from diabetic neuropathy may not be able to feel their foot, so they wouldn’t realize they had an injury,” explains Eric Yang, MD, General Surgeon on staff at the Adventist La Grange Memorial Hospital Wound Care and Hyperbaric Medicine Center. If left untreated, the cut, known as a diabetic ulcer, may not heal properly and could lead to infection.

Hope for slow-healing wounds
If a patient or their primary care doctor notices an ulcer they are often referred to the center, an award-winning facility that treats problem wounds. “About half of our patients are coming to us with type 2 diabetes,” says Dr. Yang. “Diabetic foot ulcers can be emergency situations. That can be unsettling for some patients, especially if they didn’t know there was anything wrong to begin with.”

From the time a patient arrives at the Wound Care and Hyperbaric Medicine Center, they get individualized care from a team of experts. “Every patient gets a comprehensive evaluation of their wounds and their circulation. We check for neuropathy, document the ulcers and take a detailed history of their diabetes and how well it has been controlled,” says Dr. Yang. Once the initial evaluation is complete, a customized treatment plan is created for the patient.

“We make sure to follow a specific set of evidence-based guidelines to give patients the best care possible,” Dr. Yang says. In addition to employing best practices based on the latest research, doctors at the Wound Center work with a patient’s primary care doctor or endocrinologist to make sure their diabetes and other conditions related to it are under good control. “If a person’s blood sugar is very high or very low, their wound is not going to heal,” he says.

Possible wound treatments include:
• Topical treatments
• Antibiotics (to treat infections, if any)
• Tissue-engineered skin substitutes
• Off-loading shoes
• Hyperbaric oxygen therapy

“Hyperbaric oxygen therapy is very successful when used in addition to other treatments. It isn’t something we go to right away, but if we are having difficulty getting oxygen to the wound it’s often added to a patient’s therapy,” says Dr. Yang.

During hyperbaric oxygen treatment a patient is enclosed in a tube-like chamber, called a “monochamber,” that fills with pressurized 100 percent oxygen. The high-pressure oxygen stimulates wound healing by increasing growth of new blood vessels, improving immune system function, delivering oxygen to starved tissues and increasing growth factors.

Prevention final step in healing 
The final step in any patient’s treatment is education. “Everyone at the center helps educate patients on preventing future wounds,” Dr. Yang says. “That makes coming here an intense and, we hope, rewarding experience for our patients.”

For patients with neuropathy, prevention means wearing proper shoes (nothing open-toed), not going barefoot, practicing good hygiene and examining the feet every day. “If it means having a family member look at your feet to make sure everything looks healthy, we recommend you do that,” says Dr. Yang.  Taking care of the diabetes overall and keeping any other conditions they may have under control is a big part of prevention as well.

For most patients at the Wound Care and Hyperbaric Medicine Center, needing the kind of therapy the facility provides is a wake-up call. And it works. The center has been in the nation’s top 5 percent in healing rates and patient satisfaction is high. “We give our patients lots of care and one-on-one attention. When we’re through with treatment we hope they don’t need to come back to see us again,” says Dr. Yang. “If we did our job and they took our prevention advice to heart, they won’t.”

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