A COMPARATIVE STUDY BETWEEN THE EFFECT OF TOPICAL INSULIN VS CONVENTIONAL BETADINE DRESSING ON WOUND HEALING OF DIABETIC FOOT ULCERS

Abstract

Background: Diabetic foot ulcers (DFUs) are a major complication of diabetes
mellitus, often leading to infection, poor quality of life, and lower limb amputation.
Conventional wound care typically includes betadine dressing, which, despite its
antimicrobial action, may hinder healing due to cytotoxicity. Topical insulin, with its
proliferative, angiogenic, and anti-inflammatory properties, has emerged as a
potential alternative to promote wound healing.
Objective: To compare the efficacy of topical insulin versus conventional betadine
dressing in enhancing wound healing among patients with diabetic foot ulcers.
Methods: This hospital-based, prospective, cross-sectional observational study was
conducted at the Department of General Surgery, Gadag Institute of Medical
Sciences, Karnataka, over 18 months (August 2023–February 2025). A total of 130
diabetic patients with Wagner Grade I–II foot ulcers were randomized into two
groups: topical insulin (n=65) and betadine dressing (n=65). Wound size and depth
were measured biweekly for up to 3 months. Statistical analysis was performed using
SPSS v21.0, with p ≤ 0.05 considered significant.
Results: Baseline characteristics such as age, gender, and initial ulcer dimensions
were comparable between groups. After three months, the topical insulin group
showed significantly greater reduction in ulcer size (mean reduction: 3.35 cm² vs
2.49 cm², p = 0.04) and depth (mean reduction: 0.32 cm vs 0.25 cm, p = 0.005). No
systemic adverse effects were observed. Improved granulation tissue formation was
also noted in the insulin group.
Conclusion: Topical insulin significantly accelerates wound healing in diabetic foot
ulcers compared to conventional betadine dressing, with enhanced size and depth
reduction and a favorable safety profile. It represents a promising, low-cost
therapeutic alternative, especially for resource-limited settings. Further multicenter
randomized controlled trials are needed to validate these findings and support clinical
integration.