Serious foot wounds related to diabetes heal slower in patients who suffer from depression, according to a study published in the Diabetologia journal.
Psychologists from the University of Nottingham (UK) have also observed that the rate of wound healing is influenced by the patient’s attitude towards the disease – in people who want to take control of it and actively engage in therapy, the results are paradoxically worse.
The researchers analyzed the data collected over five years among 93 patients (68 men and 25 women) who received treatment for diabetic foot in various specialist UK centers.
The name of the diabetic foot syndrome is defined as the disturbances in the blood supply and innervation of the feet accompanying diabetes, which contribute to difficult to heal wounds and ulcers that can even lead to amputation of the foot or the entire leg.
In the latest research, scientists checked the size of the wounds on the feet of each diabetic, and after 6, 12 and 24 weeks, the changes in them were assessed. At the start of the study, the patients’ blood levels of the stress hormone (ie, cortisol) were also measured, and information was gathered about their mental state and how they deal with the condition and its symptoms.
The analysis showed that depression had a strong impact on the wound healing process – it was much slower in people suffering from severe depression.
Researchers also showed that the probability of a wound healing within 24 weeks was highly dependent on the patient’s attitude towards the disease. Surprisingly, in people who wanted to take control of the symptoms of the diabetic foot and the therapy (the so-called confrontational style), wounds were less often healed after 24 weeks.
As the research leader, Prof. Kavita Vedhara, such a confrontational approach to the disease may interfere with the healing of foot ulcers as it is a long process. And when the patient’s active attitude does not bring about a quick improvement, he or she may feel stressed and frustrated, which slows healing.
Inspired by their observations, British scientists are now planning to develop a psychological therapy that will help alleviate depression in patients with diabetic foot and teach them to more effectively deal with this potentially life-threatening disease.
Diabetic foot is considered to be the leading cause of limb amputation. This is confirmed by statistics, which show that from 40 to 70 percent. all leg amputations are performed in diabetics. However, specialists estimate that as much as 85 percent. of these could be prevented, mainly due to good blood glucose control in patients. Patients with diabetes should also take special care of the hygiene of their feet – dry them well after washing, moisturize – except for the space between the toes, use seamless socks and comfortable footwear, and watch the sole of the foot in the mirror every day. (PAP)