Effect of Topical Insulin on Wound Healing in Diabetic Foot Ulcer

Samir, Aymen Mohamed; Effat, Mohamed Ahmed; Mohamed Waked, Ahmed Ibrahim; Abdelkareem Gomaa, Ahmed Mohamed

doi:10.21608/zumj.2025.400156.4035

Effect of Topical Insulin on Wound Healing in Diabetic Foot Ulcer

Document Type : Original Article

Authors

¹ Professor of Vascular Surgery, Faculty of Medicine, Zagazig University, Egypt.

² Department of vascular Surgery, Faculty of Medicine, Zagazig University, Egypt

³ Lecturer of General Surgery, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2025.400156.4035

Abstract

Background: Diabetic foot ulcers (DFU) are a serious side effect of diabetes mellitus that are associated with high rates of morbidity, mortality, and medical costs worldwide. The purpose of this study was to determine the optimal topical insulin dressing technique for diabetic foot ulcers in terms of the amount of time needed for ulcer healing and the effectiveness of insulin in comparison to conventional techniques. Methods: This prospective clinical trial was conducted at the Vascular Surgery Department, Zagazig University Hospitals, included 42 diabetic foot ulcer patients randomly assigned into two equal groups: Group A received topical insulin dressing, while Group B received saline dressing. All patients underwent thorough clinical evaluation, ulcer assessment, ABPI measurement, and baseline investigations. Topical insulin dressing was applied daily for one week followed by saline dressing for three weeks, in a repeated 12-week cycle. Ulcer dimensions (area, length, width, depth) and healing progression were assessed weekly. Results: The insulin group demonstrated significantly faster and greater reductions in ulcer area, length, width, and depth starting from the second week and persisting throughout the 12-week follow-up (p<0.05). The median healing time was significantly shorter in the insulin group (40 days) compared to the saline group (66 days) (p=0.003). Notably, 61.9% of insulin-treated ulcers achieved complete healing within 30–40 days versus none in the saline group (p=0.016). Both groups maintained adequate glycemic control throughout the study without significant adverse effects. Conclusion: These findings affirm topical insulin as an optimal dressing strategy, offering enhanced efficacy and faster recovery.

Keywords

Main Subjects