Advanced glycoxidation end products (AGEs) are implicated in delayed diabetic wound healing. To test the role of diet-derived AGE on the rate of wound healing, we placed female db/db (؉/؉) (n ؍ 55, 12 weeks old) and age-matched control db/db (؉/؊) mice (n ؍ 45) on two diets that differed only in AGE content (high [H-AGE] versus low [L-AGE] ratio, 5:1) for 3 months. Full-thickness skin wounds (1 cm) were examined histologically and for wound closure. Serum 24-h urine and skin samples were monitored for N ⑀ -carboxymethyl-lysine and methylglyoxal derivatives by enzyme-linked immunosorbent assays. L-AGE-fed mice displayed more rapid wound closure at days 7 and 14 (P < 0.005) and were closed completely by day 21 compared with H-AGE nonhealed wounds. Serum AGE levels increased by 53% in H-AGE mice and decreased by 7.8% in L-AGE mice (P < 0.04) from baseline. L-AGE mice wounds exhibited lower skin AGE deposits, increased epithelialization, angiogenesis, inflammation, granulation tissue deposition, and enhanced collagen organization up to day 21, compared with H-AGE mice. Reepithelialization was the dominant mode of wound closure in H-AGE mice compared with wound contraction that prevailed in L-AGE mice. Thus, increased diet-derived AGE intake may be a significant retardant of wound closure in diabetic mice; dietary AGE restriction may improve impaired diabetic wound healing. Diabetes 52:2805-2813, 2003 W ound healing is impaired in diabetes and constitutes a major cause for increased morbidity and mortality in patients with diabetes (1). The majority of nonhealing wounds often lead to amputation. The percentage of amputees increases with age as do the direct costs of their care, rehabilitation, and lost productivity (2) The exact cellular and molecular mechanisms underlying the pathogenesis of this complication are not fully elucidated (3,4). However, a number of hyperglycemiadependent factors have been identified, including the progressive accumulation of advanced glycation end products (AGEs) (5).Two well characterized compounds, N ⑀ -carboxymethyllysine (CML) and methylglyoxal (MG), derivatives of glucoseprotein or glucose-lipid interactions, serve as markers for AGE in a wide range of disorders related to diabetes, renal failure, and aging (6 -8). According to recent observations, AGEs can be introduced in the body by exogenous sources such as diet and possibly in amounts that exceed those caused by hyperglycemia alone. A direct correlation is shown between the amount of AGEs consumed and that found in the circulation (9,10). In vitro data show that food-derived AGEs, which include CML and MG derivatives, can mimic the actions of endogenously formed AGEs and can induce intracellular oxidative stress and inflammatory cell activation, in a manner reversible by antioxidants or anti-AGE agents (11). Animal studies have revealed a significant contribution to the total AGE pool and related pro-oxidant or proinflammatory processes by dietary AGE intake, including tissue damage; this seems to be preventable by restric...