A Randomized Controlled Trial on the Effect of Local Insulin Glargine on Venous Ulcer Healing
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Introduction: To determine whether the local administration of insulin glargine compared with placebo in nondiabetic patients with venous ulcers (VUs) leads to increased wound healing. Methods: A randomized controlled trial using a split-plot design was performed in 36 adults with leg VUs >25 cm2 and more than 3 mo of evolution. Each hemi-wound received either 10 UI insulin glargine or saline solution once a day for 7 d. Size of the wounds, thermal asymmetry, the number of blood vessels, and the percentage area of collagen content in wound biopsies were assessed at baseline and after 7 d of treatment. Blood capillary glucose was monitored once a day after the insulin injection. Results: After 7 d of treatment, the hemi-wounds treated with insulin glargine were significantly smaller, had less thermal asymmetry, more blood vessels, and more collagen content than the saline-treated side. Correlation between thermal asymmetry and the number of blood vessels was also found (r2 = 66.2, P < 0.001). No patient presented capillary glucose levels ≤3.3 mmol/L nor any adverse effects. Conclusions: In nondiabetic patients with chronic VUs, the topical administration of insulin glargine seems to be safe and promotes wound healing and tissue repair after 7 d of treatment. © 2022 Elsevier Inc.
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Angiogenesis; Granulation tissue; Insulin; Venous ulcer; Wound healing collagen; glucose; insulin glargine; lidocaine; insulin glargine; adult; Article; blood glucose monitoring; blood vessel; body temperature measurement; capillary; case report; clinical article; controlled study; drug effect; drug safety; female; follow up; glucose level; human; leg ulcer; male; middle aged; randomized controlled trial; thermography; tissue repair; ulcer healing; glucose blood level; ulcer; varicosis; wound healing; Adult; Blood Glucose; Humans; Insulin Glargine; Saline Solution; Ulcer; Varicose Ulcer; Wound Healing
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