The effect of topical insulin therapy on diabetic foot ulcers: A systematic review and meta-analysis

To systematically analyze the effect of topical insulin therapy on diabetic foot ulcers and to offer guidance for clinical practice.

We conducted a quantitative systematic review of the study in 9 representative databases for the effect of topical insulin therapy on diabetic foot ulcers. Meta-analysis was performed with Review-Manager. 5.4. This study has been registered on the official Prospero website, and the registration code is CRD42024581466.

Twelve studies involving 731 patients were included. The meta-analysis results showed that compared with conventional treatment, topical insulin therapy can reduce wound healing time (P < 0.001), and wound area (P < 0.001), inflammatory factors (serum interleukin-1, interleukin-6, tumor necrosis factor-α(P < 0.001), advanced glycation end products (P < 0.001). Additionally, it improved the degree of granulation tissue regeneration (P < 0.001), microvascular density (P < 0.001), vascular endothelial growth factor (P < 0.001), and the expression of β-catenin in wound tissue (P < 0.001). However, there was no statistically significant difference in fasting plasma glucose (P > 0.05).

Topical insulin therapy is effective in promoting wound healing and reducing inflammation in DFU patients, but its impact on blood glucose control remains uncertain. Further, high-quality RCTs are needed to confirm these findings.