State of Mind and Healing Linked in Diabetes Foot Ulcer Study

Kathleen Blanchard's picture

Scientists have found that healing of diabetes related foot ulcers differs depending on psychological state of mind. Researchers found a link between how patients with diabetes cope with potentially life threatening foot ulcers and rates of healing. The results of the study showed that anger, frustration and depression over potentially life threatening wounds associated with microvascular diabetes complications slows the rate of healing.

Professor Kavita Vedhara from the University of Nottingham says, "My colleagues and I believe that this confrontational approach may, inadvertently, be unhelpful in this context because these ulcers take a long time to heal. As a result, individuals with confrontational coping may experience distress and frustration because their attempts to take control do not result in rapid improvements." Depression was also linked to poor wound healing of diabetes related foot ulcers.

Diabetes Foot Ulcer and Healing


Patients with diabetic ulcers of the feet that can lead to amputation were monitored over 24 week period. Researchers analyzed psychological distress, coping style and levels of cortisol in saliva (a stress hormone) among 93 men and women recruited from specialist podiatry clinics across the UK. The results revealed a link between the way diabetics cope with foot ulcers and the way they heal. In a secondary analysis the scientists also found that depression also resulted in slower healing of foot ulcers.

The study suggests depression, anger and frustration with diabetes related foot ulcers can delay wound healing. Diabetics with a desire to take control or who used a "confrontational" approach to managing foot ulcers were less likely to have healed at the end of the 24 weeks of monitoring, as were those with depression.

The findings are significant. Diabetic foot ulcers develop in up to 15 percent of patients with diabetes and can lead to early mortality. Treating depression and anxiety could have a significant impact on quality of life for patients with diabetes related foot ulcers, found in the study to heal at different rates, depending on how patients cope with the condition. Psychological state of mind was found to be a factor affecting healing of diabetes related foot ulcers.

Diabetologia: DOI 10.1007/s00125-010-1743-7