Abstract

Diabetic foot ulcers (DFUs) represent a significant complication of diabetes mellitus, often leading to severe morbidity and increased healthcare costs. Objectives: The main objective of this study is to evaluate the effectiveness of topical insulin dressings versus normal saline dressings in the management of diabetic foot ulcers. Methods: This randomized controlled trial was conducted at Khyber Teaching Hospital, Peshawar, from 13th August 2023 to 3rd December 2023. Data were collected from 245 patients suffering from diabetic foot ulcers. Patients in group A received dressings with regular insulin (at a concentration of 0.1 U/cm² of ulcer area) applied directly to the ulcer, and patients in group B received dressings soaked in normal saline. Both groups received standard diabetic foot care, including debridement, offloading, and management of blood glucose levels. Results: Data were collected from 245 patients. The mean age of patients in the topical insulin group was 58.2 ± 10.4 years, and in the normal saline group, it was 59.1 ± 11.2 years. The mean duration of diabetes mellitus was 12.6 ± 6.3 years in the insulin group and 13.1 ± 5.9 years in the saline group. Baseline ulcer size was 4.5 ± 2.1 cm² in group A and 4.7 ± 2.3 cm² in group B. The insulin group showed a 65.3% reduction in ulcer size compared to 45.8% in the saline group (p<0.001), and ulcers healed faster, averaging 9.2 weeks versus 12.8 weeks (p<0.001). Conclusion: Topical insulin dressings are significantly more effective than normal saline dressings in the management of diabetic foot ulcers.