The Impact of Body Composition on Wound Healing in Type 2 Diabetes Patients: A Systematic Review

Wound healing in patients with type 2 diabetes mellitus (T2DM) presents a
major clinical challenge, particularly due to alterations in body composition
such as reduced muscle mass and increased fat mass. This systematic
review aimed to synthesize current evidence regarding the impact of body
composition on wound healing effectiveness in T2DM patients. Literature
was retrieved from PubMed, ProQuest, Wiley Online Library, and Google
Scholar, targeting observational and experimental studies published
between 2015 and 2025. Keywords included "type 2 diabetes mellitus",
"wound healing", "body composition", "sarcopenia", and "obesity". Articles
were selected based on predefined inclusion and exclusion criteria.
Methodological quality was assessed using the Critical Appraisal Skills
Programme (CASP) checklist. A total of seven eligible studies were included
and analyzed narratively. The findings from the 4 articles analyzed showed
that low muscle mass (sarcopenia) and high fat mass (obesity) were
associated with delayed wound healing in T2DM patients. Some studies
indicate that patients with better body composition balance, such as higher
muscle mass index, experience faster wound healing. Heterogeneity in
measurement methods and study populations limits the strength of these
conclusions. This review supports the hypothesis that body composition
significantly influences wound healing outcomes in T2DM. Muscle mass
reduction may impair tissue repair by limiting perfusion and immune
responses, while increased fat mass may contribute to chronic
inflammation that hinders tissue regeneration. Further longitudinal
research with standardized assessments is needed. Interventions that
promote muscle mass gain and fat mass control may be essential
components in wound management strategies for diabetic patients.