Incretin-based therapy for diabetic ulcers: from bench to bedside

ABSTRACT

Introduction: Diabetic foot ulcers are a serious complication of diabetes and are associated with pain, disability, and poor quality of life. Incretin-based therapy is available for type-2 diabetes. Aside from glucose control, such treatment can impart numerous beneficial effects.

Areas covered: This review summarizes the preclinical and clinical evidence supporting incretin-based treatment approaches for diabetic ulcers.

Expert opinion: Incretin-based therapy may have a role in the treatment of diabetic foot ulcers; the benefits of such treatment arise from attenuation of inflammatory response, improvement of keratinocyte migration, induction of angiogenesis, and the enhancement of tissue remodeling. Large-scale clinical trials are required to determine the advantages of GLP-1 receptor agonists and DPP4 inhibitors. Future research on the topical application of incretin-based therapy is necessary. Such therapeutic approaches may provide new hope in improving the treatment of impaired diabetic foot ulcers.

KEYWORDS:

• Incretin
• diabetes mellitus
• diabetic ulcer
• GLP-1
• wound healing

Article Highlights

• Antioxidant, anti-inflammatory, and proangiogenetic effects of the activation of GLP-1 receptors.

• DPP4 participates in the pathogenesis of inflammatory disorders in catalytic and non-catalytic signaling.

• Activation of GLP-1 receptors increases the expression of proangiogenetic factors.

• DPP4 inhibitors activate multiple target enzymes of chronic inflammation in wound healing.

• Incretin-based therapy has demonstrated potential benefits in the healing of diabetic foot ulcers.

• Future research on the topical application of incretin-based therapy is necessary

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.