1010-OR: Effectiveness of Topical Insulin vs. Saline Dressings for Diabetic Foot Ulcer Management: A Systematic Review and Meta-Analysis

Introduction and Objective: Diabetic foot ulcers are a common and debilitating complication of diabetes, contributing to infection risk, amputations, and health-care burden worldwide. While saline dressings remain standard care, topical insulin has been proposed as a biologically active alternative that may enhance wound healing. This study compares the effectiveness of topical insulin versus saline dressings in improving healing outcomes among patients with diabetic foot ulcers. Methods: A systematic search of PubMed, CENTRAL, Embase, Scopus, Google Scholar, and PakMediNet identified randomized and comparative studies on topical insulin versus saline dressings in diabetic foot ulcers. Outcomes included healing time, granulation tissue percentage, and ulcer area at days 1, 7, and 15. Pooled mean differences with 95% confidence intervals were calculated using random-effects models, and risk of bias was assessed with standard tools. Results: Eighteen studies met inclusion criteria, encompassing a total of 1,690 patients (832 in the topical insulin group and 838 in the saline dressing group). Topical insulin significantly reduced ulcer healing time compared with saline dressings (MD −11.60 days; 95% CI −15.32 to −7.89). Patients receiving topical insulin demonstrated a markedly higher mean percentage of granulation tissue formation (MD 23.39%; 95% CI 12.92 to 33.86). While no statistically significant difference was observed in mean ulcer area at day 1 (MD −0.31; 95% CI −0.65 to 0.03), topical insulin showed significant reductions in ulcer area at day 7 (MD −2.89; 95% CI −5.68 to −0.11) and day 15 (MD −2.25; 95% CI −4.43 to −0.06), indicating accelerated wound contraction over time. Conclusion: Topical insulin dressings accelerate diabetic foot ulcer healing more effectively than saline, improving granulation and reducing ulcer size, though larger trials are needed to confirm long-term benefits and dosing standards. Disclosure S. Hussain: None. F. Amin: None. A. Abid: None. M. Sultana: None. M. Talha: None. N. Saleem: None.