Comparison Of the Topical Insulin Versus Topical Phenytoin in Healing of Diabetic Foot Ulcers

Background: Diabetic foot ulcers represent a major complication of diabetes mellitus, leading to significant morbidity, prolonged hospitalization, and risk of amputation. Impaired wound healing due to neuropathy, ischemia, and infection necessitates effective therapeutic strategies. Topical agents such as insulin and phenytoin have shown potential in enhancing wound healing through different mechanisms, including promotion of granulation tissue and cellular proliferation, but comparative evidence remains limited.

Aims: To compare the efficacy of topical insulin versus topical phenytoin in promoting healing of diabetic foot ulcers.

Materials and Methods: This prospective comparative study was conducted over a period of 10 months and included 80 patients with diabetic foot ulcers. Patients were randomly divided into two groups of 40 each. Group I received topical insulin dressing, while Group II received topical phenytoin dressing. Ulcers were assessed at regular intervals for reduction in ulcer size, development of granulation tissue, time to healing, and infection control. Standard diabetic care, including glycemic control and debridement, was provided to all patients. Statistical analysis was performed using appropriate tests, with p < 0.05 considered significant.

Results: The mean reduction in ulcer size was significantly greater in the topical insulin group compared to the phenytoin group (p < 0.05). Early appearance of healthy granulation tissue was observed in Group I, with a higher percentage of patients showing satisfactory wound healing within a shorter duration. Infection control was comparable between the two groups. The mean duration of healing was significantly shorter in the insulin group, indicating faster wound resolution. No major adverse effects were noted in either group.

Conclusion: Topical insulin was found to be more effective than topical phenytoin in promoting faster and better healing of diabetic foot ulcers. Its ability to enhance granulation tissue formation and accelerate wound contraction makes it a promising, cost-effective therapeutic option. Incorporating topical insulin into routine wound care may improve clinical outcomes and reduce complications associated with diabetic foot ulcers.