Impact of Diabetes on Fracture Healing

Diabetes mellitus is a metabolic disorder associated with several complications, including impaired healing. Bone, as important skeletal structure in the body, is affected by the diabetic condition, particularly during fracture healing processes. In this review, we discuss the normal fracture process, as well as mechanical, histological, and molecular negative changes that take place during diabetic fracture repair. Although diabetes affects cartilages and bones from anabolic aspects, our studies have shed light on the impact of diabetes on the catabolic aspect as well. Several underlying proposed mechanisms involved in impaired diabetic fracture healing were also reviewed. Current potential therapeutic agents, which may improve the healing process, were reviewed based on the current understanding of diabetes’ impact on the various stages of fracture healing.