Decrease of Collagen Deposition in Wound Repair in Type 1 Diabetes Independent of Glycemic Control

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Abstract
IN DIABETIC foot ulcers, healing is severely impaired.1-3 It is generally assumed that glycemic control is important in optimizing wound healing. A number of animal experiments and in vitro human studies support this assumption. Experimental diabetes is associated with an impaired inflammatory response, reduced deposition of collagen, and decreased mechanical strength of incisional cutaneous or intestinal wounds, and healing is almost normalized with insulin treatment.4-8 In human studies, fibroblasts from healthy human skin have been shown to proliferate slower when cultured in high glucose levels and to acquire resistance to insulin and growth factors.9 Fibroblasts cultured from chronic wounds demonstrate impaired proliferation, in particular from diabetic foot ulcers.10

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