Arpita Bhakuni, Lalit Singh, Monika Gulia, Rahul Pratap Singh, Ashok Kumar, Vikas Jhawat
BACKGROUND: Diabetes, a chronic metabolic disorder, is associated with severe health complications, including impaired wound healing, affecting approximately 25% of diabetic individuals worldwide. Factors such as neuropathy, chronic vascular diseases, retinopathy, infections, and non-traumatic lower limb amputations contribute to the incidence and severity of diabetic wounds. OBJECTIVE: To explore the pathophysiology of diabetic wounds, the role of insulin in wound healing, and the efficacy of advanced drug delivery systems-particularly insulin-based topical formulations- in improving healing outcomes. METHODS: This review examines the impact of physiological factors, including oxidative stress, chronic inflammation, impaired angiogenesis, and hyperglycemia, on diabetic wounds. It also analyzes the role of topical insulin delivered via transferosomes entrapped in organogels in enhancing localized treatment, sustained drug release, and patient adherence. RESULTS: Insulin resistance significantly impairs wound healing by promoting oxidative stress, inflammation, and impaired angiogenesis, thereby complicating treatment. Advanced drug delivery systems, particularly insulin-based topical formulations, improve glucose regulation, enhance tissue repair, and reduce inflammation. Technologies such as transferosomes ensure sustained drug release, enhance drug efficacy, and minimize complications, resulting in superior healing outcomes compared to traditional methods. CONCLUSION: Transferosome-based organogel delivery systems incorporating insulin offer promising therapeutic approaches for diabetic wound management. By addressing specific healing challenges through targeted delivery, deeper tissue penetration, and sustained drug release, these systems improve patient adherence and quality of life, significantly enhancing healing outcomes compared to conventional treatments.