Effect of Local Insulin Injection for Wound Healing in Cases of Diabetic Foot Ulcers – A Randomized Control Trial

Abstract

Background: Diabetic foot ulcers (DFUs) are a significant complication of diabetes, affecting millions worldwide and often leading to amputations. Local insulin therapy has shown promise in enhancing wound healing in DFUs by promoting a reduction in inflammation and collagen deposition.

Objective: To evaluate the effectiveness of local insulin injections in promoting granulation tissue formation and improving outcomes in patients with DFUs.

Methods: This was a comparative prospective randomized study conducted at the Department of General Surgery, Aarupadai Veedu Medical College and Hospital, Pondicherry. A total of 102 patients, aged 20-65 years with non-healing DFUs for more than three weeks, were included – randomised, one group receiving local insulin injections with normal saline dressings and the other group receiving only normal saline dressings.

Results: The mean age of patients in the insulin and saline groups was comparable (p > 0.05). A significant reduction in ulcer size was observed by day 14 in the insulin group compared to the saline group (p < 0.05). Granulation tissue formation was significantly accelerated in the insulin group from day 3 of dressing, with a higher incidence of healthy granulation tissue (p < 0.05). Patient satisfaction was significantly higher in the insulin group (100%) compared to the saline group (13.7%) (p < 0.05).

Conclusion: Local insulin therapy significantly improved ulcer healing outcomes compared to normal saline, with faster reduction in ulcer size, earlier appearance of healthy granulation tissue, and higher patient satisfaction.