Fig. 1: Key metabolic signaling pathways in diabetic wounds.

Hyperglycemia exacerbates inflammation and oxidative stress, and disrupts energy production by promoting a metabolic shift towards glucose use. Alongside hyperglycemia, insulin resistance compounds the complexity of metabolic disturbances. Insulin resistance diminishes cells’ capacity to efficiently utilize glucose, further perpetuating the metabolic imbalances that impede the healing process. In addition, the dysregulation of lipid and amino acid metabolism additionally deepens the metabolic challenges of diabetes in wound healing.