Acknowledging the use of botanicals to treat diabetic foot ulcer during the 21^st century: A systematic review

Abstract

BACKGROUND Diabetic foot ulcer (DFU) is a serious health issue of diabetes mellitus that affects innumerable people worldwide. Management and treatment of this complication are challenging, especially for those whose immune system is weak. AIM To discuss the plants and their parts used to heal DFU, along with the mode of their administration in diabetic patients. METHODS The original articles on “the plants for the treatment of DFU” studied in clinical cases only were obtained from various bibliographic databases using different keywords. RESULTS The search resulted in 22 clinical cases records with 20 medicinal plants belonging to 17 families on 1553 subjects. The fruits and leaves were the most preferentially used parts for DFU treatment, regardless of whether they were being administered orally or applied topically. Of the 20 medicinal plants, 19 reported their effectiveness in increasing angiogenesis, epithelialization, and granulation, thus hastening the wound-healing process. The efficacy of these botanicals might be attributed to their major bioactive compounds, such as actinidin and ascorbic acid (in Actinidia deliciosa ), 7-O-(β-D-glucopyranosyl)-galactin (in Ageratina pichinchensis ), omega-3-fatty acid (in Linum usitatissimum ), isoquercetin (in Melilotus officinalis ), anthocyanins (in Myrtus communis ), and plantamajoside (in Plantago major ). CONCLUSION The validation of mechanisms of action underlying these phytocompounds contributing to the management of DFU can aid in our better understanding of creating efficient treatment options for DFU and its associated problems.

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta‐analysis of randomized controlled trials

“…73 , 74 However, the safety and effectiveness of this complementary intervention are still challenging. 27 Although recent reviews have investigated the potential impact of administrating herbal preparations on treating DFU, their findings are inconclusive; thus, a more comprehensive evidence‐based study on this topic is crucial. 37 Accordingly, we executed this systematic review with meta‐analysis to augment the previous reviews and provide more evidence for the potential effects of topical application and oral intake of herbal products on treating DFU.…”

“… 21 , 22 , 23 , 24 , 25 , 26 Systematic reviews, which are at the top of the clinical evidence hierarchy, have recently addressed the potential effect of herbal products in healing DFU; however, they either focused on metabolites and phytoconstituents of used herbs or synthesized the results of investigations with different study designs, making it difficult to draw a reliable conclusion. 27 , 28 , 29 , 30 On the contrary, reviews that performed a meta‐analysis or comprehensive synthesis included only studies conducted in China or evaluated Chinese Herbal Medicines (CHM), which may limit the generalizability and applicability of their findings. 31 , 32 , 33 , 34 , 35 , 36 , 37 Yet, recent randomized controlled trials (RCTs) performed in different regions have reported inconsistent findings regarding the potential efficacy of herbal medications in healing DFU.…”