Lower limb ulcers in diabetic patients: molecular and cellular mechanisms

Abstract

Diabetes depictures a heterogeneous group of metabolic disorders that arise as a result of hyperglycemia due to the deficit of secretion and/or insulin action. Its prevalence and related costs have been growing around the world. Among its long-term complications, foot ulcer is the one that generates more hospital admissions. These wounds often become chronic due to a series of molecular and cellular aberrations of the healing process, being the main mechanisms the following: high concentrations of matrix metalloproteinases (MMPs), neuropathy, high probability of infection and non-physiological inflammatory response, oxidative stress, excessive formation of AGEs (advanced glicoxidation end-products), deficient neoangiogenesis, imbalance between metabolism and nutrient delivery, inadequate concentrations of growth factors and gene expression regulators, and cellular abnormalities. With better scientific understanding of these events and physiological healing, new approaches to disease can provide more satisfactory results to the treatment