What mechanisms link chronic hyperglycemia to impaired wound healing and infection risk?

• A. Nonenzymatic glycation and immune dysfunction
• B. Bacterial infection and poor perfusion
• C. Increased collagen synthesis
• D. Improved wound healing

Answer: (A)

Chronic hyperglycemia harms wound healing and raises infection risk mainly through nonenzymatic glycation forming advanced glycation end products (AGEs) and through immune dysfunction. AGEs accumulate in tissues and cross-link collagen, altering the wound matrix and stiffening the extracellular environment, which slows normal remodeling and closure. The AGE–RAGE interaction also drives oxidative stress and a persistent inflammatory state that damages microvasculature, reducing blood flow and oxygen delivery to healing tissue. At the same time, high glucose impairs innate immune cell functions—neutrophil chemotaxis, phagocytosis, and microbial killing—making infections more likely and prolonging inflammation. Together, these mechanisms explain both delayed wound healing and higher infection risk.