Impact of Diabetes on the Protective Role of FOXO1 in Wound Healing

Abstract

Diabetes mellitus is a heterogeneous group of disorders characterized by high blood glucose levels. It is projected that by 2025 there will be 300 million people afflicted with diabetes worldwide (Kaul et al. 2012). There are numbers of complications caused by diabetes, including increased heart disease, stroke, blindness, kidney failure, and delayed wound healing. Diabetes affects the oral cavity by increasing the prevalence of caries, gingivitis, periodontal disease, implantitis, fibromas, and traumatic ulcers (Guggenheimer et al. 2000). Chronic diabetic wounds affect up to one-fourth of diabetic patients (Eming et al. 2014), and oral soft tissue lesions are twice as prevalent (Guggenheimer et al. 2000). A number of factors may contribute to impaired healing in diabetics, such as increased blood glucose levels that cause metabolic distress at the cellular level, greater formation of advanced glycation endproducts (AGEs) that form as a result of increased glucose, increased expression of inflammatory cytokines, and elevated oxidative stress (Hameedaldeen et al. 2014).