CD40LG and diabetes mellitus: Additionally, diabetes leads to increased oxidative stress and proinflammatory cytokines such as TNF-α, IL-6, soluble E-selectin, soluble CD40L, soluble intercellular adhesion molecule, C-reactive protein, and monocyte chemoattractant protein, further complicating flap healing.14The use of PRP has been described as an adjunctive therapy with superior results for conditions resulting from microvascular complications in diabetic patients, for instance, in diabetic foot ulcers.15