Hubungan terapi insulin sistemik dan kontrol glikemik terhadap penyembuhan ulkus kaki diabetik: A systematic review
DOI: https://doi.org/10.56922/pti.v6i2.3555
Diabetes Mellitus Diabetic Foot Ulcer Systemic Insulin Therapy Systematic Review Wound Healing
Abstract
Background: Diabetic ulcers are a chronic complication of diabetes mellitus that contribute significantly to morbidity, amputation risk, and healthcare system burden. Optimal glycemic control plays a crucial role in wound healing. Systemic insulin therapy is a key strategy for glycemic control, with various regimens used in clinical practice.
Purpose: To determine the relationship between systemic insulin therapy and glycemic control on the healing of diabetic foot ulcers.
Methods: This systematic review was compiled based on the PRISMA 2020 guidelines. A literature search was conducted on PubMed, ScienceDirect, OpenAlex, the Cochrane Library, and Google Scholar. Inclusion criteria included studies in diabetic patients with ulcers that used systemic insulin as an intervention and reported outcomes related to wound healing. Article selection, data extraction, and risk of bias assessment were conducted systematically according to the study protocol.
Results: Most studies have shown a link between better glycemic control, including in patients receiving systemic insulin therapy, and improved wound healing. Several studies have reported increased wound healing rates, improved granulation tissue formation, and reduced wound complications in patients receiving insulin therapy.
Conclusion: Available evidence suggests an association between systemic insulin therapy, improved glycemic control, and improved healing outcomes in diabetic foot ulcers. However, interpretation of the results is inconsistent. Some studies evaluate insulin therapy directly, while others evaluate glycemic control as a factor associated with wound healing.
Keywords: Diabetes Mellitus; Diabetic Foot Ulcer; Systemic Insulin Therapy; Systematic Review; Wound Healing.
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References
American Diabetes Association Professional Practice Committee. (2026). Standards of care in diabetes—2026. Diabetes Care, 49(Suppl. 1), S1–S350. Diakses dari: https://diabetesjournals.org/care/issue/49/-Supplement_1
Armstrong, D. G., Boulton, A. J., & Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. New England Journal of Medicine, 376(24), 2367-2375.
Baid, S., Sharma, R. K., Sharma, M., & Sharma, S. E. (2025). Efficacy of topical insulin versus normal saline in promoting granulation tissue formation and healing in diabetic foot ulcers: A prospective non-randomized interventional comparative study. International Surgery Journal, 12(9), 1492–1496.
Bautista, A. P., Haruka, I. M., Mai, N. T., Ngan, K. H., & Charlotte, C. S. (2025). Effectiveness of Comprehensive Therapy vs. Standard Treatment in Diabetic Foot Ulcer Healing: A Retrospective Cohort Study. Journal of Wound Research and Technology, 2(1), 1-6.
Bhat, S. Z., Al-Hajri, N., Kanbour, S., Ahmadzada, M., Borovoy, A., Abusamaan, M. S., & Mathioudakis, N. (2024). Glycemic management in diabetic foot ulcers: A comparative analysis of wound and wound-free periods in adults with type 1 and type 2 diabetes. Canadian journal of diabetes, 48(8), 517-523.
Deepthi, S. S., Rojaramani, K., Kumar, S., Rani, G. P., & Raja, B. G. (2025). To study the efficacy of topical insulin application in wound healing in diabetic ulcers. International Journal of Current Pharmaceutical Review and Research, 17(6), 889–894.
Dutta, A., Bhansali, A., & Rastogi, A. (2023). Early and intensive glycemic control for diabetic foot ulcer healing: a prospective observational nested cohort study. The International Journal of Lower Extremity Wounds, 22(3), 578-587.
Farrow, F., Fountoulakis, N., Cummins, K., Sharma, A., Mahmood, R., Vas, P., & Karalliedde, J. (2021). Cardiac autonomic neuropathy is associated with improved diabetic foot ulcer healing: A single centre prospective cohort study. Experimental and Clinical Endocrinology & Diabetes, 129(12), 895-898.
Glanville, J., & Lefebvre, C. (2022). Identifying randomized controlled trials. Systematic Reviews in Health Research: Meta‐Analysis in Context, 36-54.
Hariyati, F., Hasmono, D., & Kasih, E. (2018). Profil penggunaan insulin pada pasien diabetes melitus tipe 2 dengan ulkus/gangren di Rumah Sakit Umum Daerah (RSUD) Kabupaten Sidoarjo. Jurnal Farmasi Sains dan Terapan (Journal of Pharmacy Science and Practice), 5(1), 30-37.
Lukito, J. I. (2020). Tinjauan atas terapi insulin. Cermin Dunia Kedokteran, 47(7), 525-529.
Omotosho, I. A., Shamsuddin, N., Zaman Huri, H., Chong, W. L., & Rehman, I. U. (2025). From control to cure: Insights into the synergy of glycemic and antibiotic management in modulating the severity and outcomes of diabetic foot ulcers. International Journal of Molecular Sciences, 26(14), 6909.
Schaper, N. C., van Netten, J. J., Apelqvist, J., Bus, S. A., Fitridge, R., Game, F., & IWGDF Editorial Board. (2024). Practical guidelines on the prevention and management of diabetes‐related foot disease (IWGDF 2023 update). Diabetes/Metabolism Research and Reviews, 40(3), e3657.
Shi, X., Wang, L., & Zhang, Q. (2021). Metabolic factors associated with the severity of diabetic foot ulcers: A multicenter cross-sectional study. Journal of Endocrinology and Metabolism, 15(3), 124–132
Sridharan, K., & Sivaramakrishnan, G. (2017). Efficacy of topical insulin in wound healing: A preliminary systematic review and meta‐analysis of randomized controlled trials. Wound Repair and Regeneration, 25(2), 279-287.
Srinivasan, R., Sinha, A., Tentolouris, N., & Jude, E. B. (2025). Impact of continuous glucose monitoring on glycemic control in type 2 patients with diabetic foot ulcers: a pilot study. The International Journal of Lower Extremity Wounds, 15347346251369622.
Sterne, J. A., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., & Higgins, J. P. (2019). RoB 2: a revised tool for assessing risk of bias in randomised trials. bmj, 366.
Vangaveti, V. N., Jhamb, S., Hayes, O., Goodall, J., Bulbrook, J., Robertson, K., & Malabu, U. H. (2022). Effects of vildagliptin on wound healing and markers of inflammation in patients with type 2 diabetic foot ulcer: a prospective, randomized, double-blind, placebo-controlled, single-center study. Diabetology & Metabolic Syndrome, 14(1), 183.
Vatankhah, N., Jahangiri, Y., Landry, G. J., Moneta, G. L., & Azarbal, A. F. (2017). Effect of systemic insulin treatment on diabetic wound healing. Wound Repair and Regeneration, 25(2), 288-291.
Wang, X., Yuan, C. X., Xu, B., & Yu, Z. (2022). Diabetic foot ulcers: Classification, risk factors and management. World journal of diabetes, 13(12), 1049.
Wiyono, M., & Setyawan, Y. (2025). Association of Blood Glucose Control with Wound Healing in Patients with Diabetes Mellitus. Jurnal Citra Keperawatan, 13(2), 112-120.
Xiang, J., Wang, S., He, Y., Xu, L., Zhang, S., & Tang, Z. (2019). Reasonable glycemic control would help wound healing during the treatment of diabetic foot ulcers. Diabetes Therapy, 10(1), 95-105.
Zhang, X., Yan, D., Du, T., Zhao, Y., Zhang, J., Zhang, T., & Li, W. (2023). Efficacy and safety of basal-bolus insulin at 1: 1.5 ratio compared to 1: 1 ratio using a weight-based initiation and titration (WIT2) algorithm in hospitalized patients with type 2 Diabetes: a multicenter, randomized, clinical study. Diabetology & Metabolic Syndrome, 15(1), 243.
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