A Randomized Controlled Trial on the Effect of Local Insulin Glargine on Venous Ulcer Healing

J Surg Res. 2022 Nov:279:657-665. doi: 10.1016/j.jss.2022.06.070. Epub 2022 Aug 3.

Abstract

Introduction: To determine whether the local administration of insulin glargine compared with placebo in nondiabetic patients with venous ulcers (VUs) leads to increased wound healing.

Methods: A randomized controlled trial using a split-plot design was performed in 36 adults with leg VUs >25 cm2 and more than 3 mo of evolution. Each hemi-wound received either 10 UI insulin glargine or saline solution once a day for 7 d. Size of the wounds, thermal asymmetry, the number of blood vessels, and the percentage area of collagen content in wound biopsies were assessed at baseline and after 7 d of treatment. Blood capillary glucose was monitored once a day after the insulin injection.

Results: After 7 d of treatment, the hemi-wounds treated with insulin glargine were significantly smaller, had less thermal asymmetry, more blood vessels, and more collagen content than the saline-treated side. Correlation between thermal asymmetry and the number of blood vessels was also found (r2 = 66.2, P < 0.001). No patient presented capillary glucose levels ≤3.3 mmol/L nor any adverse effects.

Conclusions: In nondiabetic patients with chronic VUs, the topical administration of insulin glargine seems to be safe and promotes wound healing and tissue repair after 7 d of treatment.

Trial registration: ClinicalTrials.gov NCT04310280.

Keywords: Angiogenesis; Granulation tissue; Insulin; Venous ulcer; Wound healing.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose
  • Humans
  • Insulin Glargine / pharmacology
  • Insulin Glargine / therapeutic use
  • Saline Solution
  • Ulcer
  • Varicose Ulcer* / drug therapy
  • Wound Healing

Substances

  • Blood Glucose
  • Saline Solution
  • Insulin Glargine

Associated data

  • ClinicalTrials.gov/NCT04310280