Pharmacotherapeutic Evaluation of Topical Insulin Versus Medicinal Honey Dressing in the Management of Diabetic Foot Ulcers among Patients with Diabetes Mellitus: A Randomized Controlled Trial.

BACKGROUND: Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus and a major cause of morbidity and lower limb amputation. Effective pharmacological interventions that enhance wound healing are essential for DFU management. Topical insulin has been shown to promote cellular proliferation and angiogenesis, whereas medicinal honey possesses antimicrobial, anti-inflammatory, and tissue regenerative properties. OBJECTIVE: To compare the effectiveness of topical insulin therapy and medicinal honey dressing in promoting wound healing among patients with DFU. METHODS: A randomized controlled superiority trial with a four-group pre-test and post-test design was conducted among 120 patients with Wagner grade I and II DFU. Participants were allocated into four experimental arms (n = 30 each). Experimental arms I and III received topical insulin dressing, whereas experimental arms II and IV received medicinal honey dressing. Wound healing was evaluated using the Bates-Jensen Wound Assessment Tool (BWAT) before and after intervention. RESULTS: Both interventions significantly improved wound healing scores (P < 0.001). In the insulin groups, the paired t-test values were 16.91 and 15.91, while the honey dressing groups showed greater improvement with t-values of 22.35 and 28.17. The post-test mean wound scores were significantly lower in the honey dressing groups compared to the insulin groups, indicating enhanced healing. CONCLUSION: Both topical insulin and medicinal honey dressing are effective pharmacological adjuncts for DFU management. However, medicinal honey dressing demonstrated superior efficacy in promoting wound healing among patients with diabetes mellitus.