Advanced Drug Delivery Systems for Topical Insulin in Diabetic Wound Healing

Diabetes mellitus is a chronic condition characterized by impaired insulin production or utilization, leading to serious complications such as diabetic foot ulcers (DFUs). DFUs are chronic wounds with high levels of inflammatory cytokines, arterial occlusion, and persistent infection, often resulting in significant morbidity. Traditional treatment methods, including debridement, offloading, and infection control, have shown limited success, prompting the exploration of novel therapeutic strategies. Insulin, known for its role in glucose metabolism, also possesses wound-healing properties by promoting cell proliferation, protein synthesis, and modulating inflammation. However, systemic insulin administration is not ideal due to hypoglycemia risks and difficulties in achieving therapeutic concentrations at wound sites. This review focuses on advanced drug delivery systems for the topical application of insulin in wound dressings. Various delivery platforms, including hydrogels, nanoparticles, liposomes, and microemulsions have been developed to optimize insulin bioavailability, protect it from degradation, and ensure controlled release. These systems aim to enhance the management of diabetic wounds by addressing the multifactorial nature of wound healing complications in diabetic patients. The review provides a comprehensive overview of current advancements, evaluates the efficacy of these systems in preclinical and clinical studies, and discusses the challenges and future perspectives in this field. By highlighting the potential of these innovative approaches, this review underscores the promise of advanced topical insulin delivery systems in improving diabetic wound management and patient outcomes.