Effect of topical insulin in diabetic foot ulcer healing among patients with diabetes in Asia: a systematic review.

In 30 seconds

This systematic review assessed topical insulin for diabetic foot ulcer healing in patients with diabetes in Asian countries. It included observational studies and randomised controlled trials published between 2016 and 2024. Sixteen studies reporting on 1056 patients were selected from 1132 records identified in the initial search. Eight studies reported wound healing in terms of wound-size reduction. The review concluded that the findings support topical insulin as an adjunct for DFU healing, while noting that several patient-centred and resource-use outcomes were not evaluated.

Key findings

• Sixteen studies involving 1056 patients were included in the review.
• Eight studies reported wound healing using reduction in wound size.
• No included study assessed hospitalisation days, dressing changes, insulin applications, quality of life, cost-effectiveness, anxiety, or depression.

Why it matters

The review brings together evidence on topical insulin for DFUs in Asian populations and identifies important gaps beyond wound-size outcomes. Clinicians and researchers should interpret the supportive conclusion alongside the limited range of outcomes reported; the review does not provide a single pooled estimate of treatment effect in the abstract.

What to keep in mind

The review included both observational and randomised studies, and the abstract reports no pooled effect estimate. Several clinically relevant outcomes, including quality of life and resource use, were not assessed in the included studies.