The adverse effects of persistent wound stress on patients with type 2 diabetes. Part 2: Therapeutic strategies and tissue engineering approaches.

Abstract

Chronic wounds in patients with type 2 diabetes mellitus reflect persistent wound stress and its interaction with systemic metabolic and inflammatory disorders. Building on this concept, this review summarises therapeutic strategies aimed at relieving local wound stress while protecting organ function. We first outline conventional regimens for wound management in type 2 diabetes mellitus, including glycaemic optimisation, anti-infective therapy, microcirculatory support, antioxidant and anti-inflammatory interventions, promotion of angiogenesis and neural repair, and comprehensive local care (debridement, dressings, negative-pressure therapy and multidisciplinary management). We then discuss tissue-engineering approaches that combine cells, bioactive factors, and advanced biomaterials or three-dimensional printing to reconstruct a pro-healing microenvironment, enhance neovascularisation and re-epithelialisation, and reduce systemic stress responses. Finally, we propose coordinated local wound repair and systemic stress regulation as a potential strategy to interrupt the cycle of persistent wound stress and multi-organ injury in type 2 diabetes mellitus.