Novel biological therapies for the treatment of diabetic foot ulcers

Abstract

The number of people with diabetes mellitus (DM) is estimated to exceed 640 million by the year 2040. Diabetic foot ulcer (DFU) is a debilitating illness that affects more than 2% of DM patients. DFU is caused by DM-induced neural and vascular lesions leading to a reduced sensation and microcirculation. The increase in the prevalence of DFU has prompted researchers to find new therapies for the management of DFU. Areas covered: This review presents the current status of novel biological therapies used in the treatment of DFU. Literature information and data analysis were collected from PubMed, the website of the American Diabetes Association, and ClinicalTrials.gov. The keywords used in the search were: DM, DFU, complications of DM. Expert opinion: Many biological agents have been investigated in a bid to find an effective therapy for DFU. These include growth factors (platelet-derived growth factor, vascular endothelial growth factor etc), stem cells (epithelial progenitor-, adipose-derived stem cells etc), anti-diabetic drugs (insulin, exendin-4), herbs, urokinase, dalteparin, statins and bio-agents such as acid peptide matrix. Biological agents that can reduce hyperglycaemia, increase sensation, microcirculation and oxygenation and repair lost tissue are the most ideal for the treatment of DFU.

Ointments containing Ceratothoa oestroides extract: Evaluation of their healing potential in the treatment of diabetic foot ulcers

“…Current treatment for DFUs includes surgical debridement and drainage, antimicrobial therapy for infected wounds, pressure offloading methods and advanced wound dressings, as well as new alternative interventions. [4][5][6][7][8] Despite this progress, lower extremity amputations in diabetic patients still occur at a significantly higher rate than in nondiabetic individuals. 9,10 Approximately 85% of amputations in diabetic patients are preceded by a foot ulceration that may deteriorate to severe gangrene or infection.…”

Cost‐effectiveness of prevention and management of diabetic foot ulcer and amputation in a health resource‐limited setting

“…Second, simplistic treatment choices were used in this analysis to simplify the model, which may not reflect real‐world practice. Recent studies have found that novel biological therapies and new techniques, such as growth factors and bioengineered skin, resulted in very promising breakthroughs in the treatment of DFU; nevertheless, we did not take this into account in the present analysis because these techniques are not widely prescribed currently in China. In addition, we did not measure the effect of patient compliance.…”

The use of fat grafting and platelet‐rich plasma for wound healing: A review of the current evidence

“…Diabetes is one of the world's most common diseases and a large minority of patients will go on to develop non‐healing wounds . Conventional treatment options of wound care and infection prevention are costly to the health service with inconsistent efficacy . Diabetic wounds are in a state of chronic inflammation with impairment in all the physiological and biochemical wound‐healing processes including angiogeneis, cellular differentiation, and growth factor production .…”

“…156 Conventional treatment options of wound care and infection prevention are costly to the health service with inconsistent efficacy. 157 Diabetic wounds are in a state of chronic inflammation with impairment in all the physiological and biochemical wound-healing processes including angiogeneis, cellular differentiation, and growth factor production. 158 Given the prevalence of diabetic wounds, the regenerative potential of fat, the low cost, safe, and straightforwardness of conventional fat grafting, there may be a role for it in treating these patients.…”