Effect of Topical Insulin on Second-Degree Burns in Diabetic Rats

Azevedo, Flávia Figueiredo; Pessoa, Ana Flávia Marçal; Moreira, Geraldo Eustáquio; Santos, Marinilce Fagundes dos; Liberti, Édson Aparecido; Araujo, Eliana P.; Carvalho, Cibele Figueira; Saad, Mário José Abdalla; Lima, Maria Helena Melo

doi:10.1177/1099800415592175

Cited by 41 publications

(50 citation statements)

References 38 publications

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“…More recently topical application of insulin has been shown to accelerate healing of diabetic ulcers; however, its mechanism was not fully understood. Although effect of insulin was ascribed to its glucose control properties, later studies revealed different mechanisms through which insulin improves wound healing . In our study using systemic insulin therapy was associated with higher rates of complete wound healing even after adjusting for multiple confounding covariate, including blood glucose control.…”

Section: Discussionmentioning

confidence: 43%

“…Although effect of insulin was ascribed to its glucose control properties, 12 later studies revealed different mechanisms through which insulin improves wound healing. 13,14 In our study using systemic insulin therapy was associated with higher rates of complete wound healing even after adjusting for multiple confounding covariate, including blood glucose control. The independent association of insulin therapy with higher rates of complete wound healing contends mechanisms other than blood glucose control for insulin.…”

Section: Discussionmentioning

confidence: 56%

“…Increased microvessel density and growth of granulation tissue has been reported in patients with diabetic foot ulcers after topical injection of insulin compared to control group . Topical insulin may improve wound healing even in healthy animals, reduce the duration of the inflammatory phase, and improve wound reepithelialization . Topical insulin may accelerate healing of diabetic and nondiabetic wounds by enhancing the serine‐threonine kinase (AKT) and extracellular signal‐regulated kinase (ERK) pathways and increased expression of endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), and stromal cell‐derived factor (SDF‐1alpha) .…”

Section: Discussionmentioning

confidence: 99%

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Effect of systemic insulin treatment on diabetic wound healing

Vatankhah

Jahangiri

Landry³

et al. 2017

Wound Repair Regeneration

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This study investigates if different diabetic treatment regimens affects diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a non-healing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics and outcome were collected. Non-healing wound was defined as major or minor amputation or those who didn’t have complete healing until the last observation. Median age was 60.0 years (range: 31.1–90.1) and 58 cases (68.2%) were males. Twenty-four cases reached a complete healing (healing rate: 22.4%). Median follow-up period in subjects with classified as having chronic wounds was 6.0 months (range: 0.7–21.8). Insulin treatment was a part of diabetes management in 52 (61.2%) cases. Insulin therapy significantly increased the wound healing rate (30.3% [20/66 ulcers] vs. 9.8% [4/41 ulcers]) (P=0.013). In multivariate random-effect logistic regression model, adjusting for age, gender, smoking status, type of diabetes, hypertension, chronic kidney disease, peripheral arterial disease, oral hypoglycemic use, wound infection, involved side, presence of Charcot’s deformity, gangrene, osteomyelitis on x-ray, and serum hemoglobin A1C levels, insulin treatment was associated with a higher chance of complete healing (beta±SE: 15.2±6.1, P=0.013). Systemic insulin treatment can improve wound healing in diabetic ulcers after adjusting for multiple confounding covariates.

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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of systemic insulin treatment on diabetic wound healing

Vatankhah

Jahangiri

Landry³

et al. 2017

Wound Repair Regeneration

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“…The wound healing disorder in diabetes can be attributed to various factors, such as weak blood supply, reduced proliferative potential and low infl ammatory changes [16] . Some burn, surgical incision or diabetic wound animal studies were demonstrated that inadequate or non-healing wounds can be treated with topical insulin application [17][18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Bir Vervet Maymununun Gluteal Bölgesindeki Maddi Kayıplı Deri Yarasının Topikal İnsülin İle Sağaltımı

GÜLTEKİN¹,

ULUKAN²,

Özdemir³

et al. 2019

Kafkas Univ Vet Fak Derg

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In a female vervet monkey brought to our hospital with the complaint of anaphylactic shock depending on snake bite, a gangrenous wound was detected in right gluteal region and traditional local cicatrizing and epithelizing pomade application and systemic treatment were performed for 10 days. As no signs of epithelization and shrinkiage was observed during this treatment, a new treatment protocol was started with topical insulin pomade. It was determined that epithelization started on the 4 th days and completely recovered on the 46th days of the treatment and 30 days after the completion of topical insulin treatment the wound region was became hairy. It was concluded that topical treatment with insulin pomade had positive effects on delayed secondary wound healing in vervet monkeys whom their cutaneous trunci muscle (M. panniculus carnosus) responsible for wound contraction was not functional. ÖzHastanemize yılan ısırığına bağlı anaflaktik şok şikayeti ile getirilen dişi vervet maymununda, sağ gluteal bölgede gangrenli deri yarası tespit edildikten sonra 10 gün boyunca geleneksel lokal sikatrizan ve epitelizan pomat uygulamaları ve sistemik sağaltım yapıldı. Yarada epitelizasyon ve küçülmenin hiç gözlenmemesi üzerine topikal insulin pomat uygulamasına geçildi. Uygulamanın 4. gününde epitelizasyonun başladığı, 46. günde tamamlandığı, topikal insulin sağaltımının kesilmesinden sonra 30. günde ise epitelizasyon bölgesinin tüylendiği gözlendi. Sonuç olarak, yaranın kontraksiyonla küçülmesini sağlayan cutaneous trunci (M. panniculus carnosus) kasının non-human primatlarda fonksiyonel olmadığı, topikal insülin pomat uygulamalarının gecikmiş sekunder yara iyileşmesinde pozitif katkıları olduğu gözlendi.

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“…The problem of how to continually release insulin in an effective manner to promote the growth of granulation tissue and wound healing is a known concern (9). Previous findings have shown that local infiltration injections increase the absorption efficiency of insulin while exerting little influence on blood sugar contents (10). The possibility that insulin may promote wound healing following simple deep burn skin flap transplantation in humans and its possible mechanism were analyzed in this clinical case-control study.…”

Section: Discussionmentioning

confidence: 99%

Clinical study on local application of low-dose insulin for promoting wound healing after operation for deep burns

Zeng

Zhi

Liu

et al. 2016

Experimental and Therapeutic Medicine

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Transplanted free skin flaps are often needed to treat deep burns; their survival, however, is less than optimal. This study examined whether local low-dose insulin injections can promote flap survival and wound healing after surgery. A total of 165 patients who underwent free skin flap transplantation for simple deep burns were enrolled in the study and divided into 5 groups of 33 patients each: Blank control group (no local subcutaneous drug injections), saline control group (saline injections), low-dose insulin group (0.5 units regular insulin injections), medium-dose group (1.0 units regular insulin injections) and high-dose group (2.0 units regular insulin injections). Wound healing and flap survival conditions were assessed and compared among groups. The best wound healing rate found was that of the low-dose insulin injection group where all the parameters measured improved significantly: The healing time was shorter; the blood flow volume, the flap survival, the number of fibroblasts and new vessels increased; the re-epithelialization occurred faster; the infiltration of inflammatory cells was reduced; the expression levels of heat shock protein-90, vascular endothelial growth factor, transforming growth factor-β and interleukin-1 were higher; and the plasma glucose levels only fluctuated slightly. The results clearly demonstrate that a local low-dose insulin regime after flap transplantation can accelerate the healing time and improve the surgical outcome without exerting detrimental secondary effects on the glucose plasma level of deep burn patients.

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Effect of Topical Insulin on Second-Degree Burns in Diabetic Rats

Cited by 41 publications

References 38 publications

Effect of systemic insulin treatment on diabetic wound healing

Effect of systemic insulin treatment on diabetic wound healing

Bir Vervet Maymununun Gluteal Bölgesindeki Maddi Kayıplı Deri Yarasının Topikal İnsülin İle Sağaltımı

Clinical study on local application of low-dose insulin for promoting wound healing after operation for deep burns

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