GE s ▁on ▁l amin in ▁result ▁in ▁reduced ▁binding ▁to ▁type ▁IV ▁col lagen ▁in ▁the ▁bas ement ▁memb rane , ▁reduced ▁polym er ▁el ong ation ▁and ▁reduced ▁binding ▁of ▁he par an ▁sul f ate ▁prote og ly can . ▁ ▁Imp a ired ▁NO ▁synth esis ▁N it ric ▁ox ide ▁is ▁known ▁as ▁an ▁important ▁stim ulator ▁of ▁cell ▁pro l ifer ation , ▁m atur ation ▁and ▁different iation . ▁Thus , ▁nit ric ▁ox ide ▁increases ▁fib ro blast ▁pro l ifer ation ▁and ▁thereby ▁col lagen ▁production ▁in ▁w ound ▁he aling . ▁Also , ▁L - argin ine ▁and ▁nit ric ▁ox ide ▁are ▁required ▁for ▁proper ▁cross ▁linking ▁of ▁col lagen ▁fib ers , ▁via ▁pro line , ▁to ▁minim ize ▁sc arring ▁and ▁maxim ize ▁the ▁tens ile ▁strength ▁of ▁he aled ▁t issue . ▁End oth el ial ▁cell ▁specific ▁nit ric ▁ox ide ▁synth ase ▁( E c N OS ) ▁is ▁activ ated ▁by ▁the ▁p uls atile ▁flow ▁of ▁blood ▁through ▁vessels . ▁N it ric ▁ox ide ▁produced ▁by ▁E c N OS , ▁maintain s ▁the ▁diameter ▁of ▁blood ▁vessels ▁and ▁proper ▁blood ▁flow ▁to ▁t issues . ▁In ▁addition ▁to ▁this , ▁nit ric ▁ox ide ▁also ▁regul ates ▁ang i ogen esis , ▁which ▁plays ▁a ▁major ▁role ▁in ▁w ound ▁he aling . ▁Thus , ▁di ab etic ▁patients ▁exhib it ▁reduced ▁ability ▁to ▁generate ▁nit ric ▁ox ide ▁from ▁L - argin