Endothelium Disfunction Distracts Wound Healing Of Diabetics

Diabetes Mellitus (DM) is non-communicable prevalent disease and has been in increase from year to year. According to the WHO estimation, patients with DM in Indonesia in 2000 accounted for 5.6 million, this increased to 14 million in 2006. This number is expected to be 6.3% of the total world population in 2025. In diabetics insulin resistance occurs, the failure of the pancreatic beta cells to lower the amount of insulin circulation. Decrease in insulin function is as a result of the glucose transporter derived from daily consumption that cannot be converted to energy, this leads to hyperglycemia. This causes the activation pathways polyols, AGEs, PKC and hexosamine (Glena). This result in increase of ROS derived from mitochondria, resulting in endothelial dysfunction. Endothelial dysfunction induces failure of formation of acute phase proteins, antioxidants immunonutrition, deficiency of oxygen and nutrients to the injured blood vessels. This impairs wound healing in diabetes. The process of wound healing requires a high energy intake with a low glycemic index. The management is aimed to plan a healthy diet and lifestyle so that blood glucose levels, blood pressure, blood lipid are in control.