System Sundays: NO GUTS, NO GLORY: Microbiome, Diabetes, and Wound Healing

This episode explains how the gut microbiome — an internal ecosystem of bacteria, fungi, and viruses — regulates inflammation, immunity, metabolism, and wound healing, and how diabetes disrupts that balance. High blood sugar, altered gut conditions, and repeated antibiotics can cause dysbiosis and leaky gut, driving chronic systemic inflammation, immune dysfunction, biofilm formation, impaired angiogenesis and collagen synthesis, and stalled diabetic wound healing. Practical approaches discussed include glycemic control, nutrition (fiber and fermented foods), targeted probiotics/prebiotics, exercise, sleep and stress management, antibiotic stewardship, and multidisciplinary care to support both the gut and the wound for better limb salvage outcomes.