The global epidemiology of diabetic foot ulcers has been reported to have a prevalence of 6.3%, which was higher in males than females, and in patients with type 2 diabetes mellitus than in those with type 1 (6.4% vs 5.5%). The global health expenditure on diabetes mellitus is estimated to reach US$ 1,054 billion by 2045, increasing 9.1% from US$ 966 billion in 2021. The 10th edition of the International Diabetes Federation Atlas has reported that the number of patients suffering from diabetes mellitus in 2021 was 536.6 million, and there will be approximately 783.2 million adults with diabetes by 2045. This paper discusses biomaterial-based MSCs therapies in diabetic wound healing and highlights the low conversion rate to clinical trials and commercially available therapeutic products.ĭiabetic foot ulcers are the main cause of amputation in patients with diabetes mellitus, resulting in high healthcare costs, reduced quality of life and increased mortality. To this end, various biomaterial conformations have emerged as MSC delivery vehicles to enhance cell viability and persistence at the site of implantation. However, topical administration of MSCs via direct injection has several disadvantages, including low cell viability and poor cell localization at the wound bed. While a number of different cell types have been studied, the therapeutic use of mesenchymal stromal cells (MSCs) has been widely reported to improve delayed wound healing. Delivery of stem cells may be a promising approach to enhance wound healing because of their paracrine properties, including the secretion of angiogenic, immunomodulatory and anti-inflammatory factors.
Patients with non-healing diabetic ulcers may require amputation, creating an urgent need for new reparative treatments. The cause of impaired wound healing in diabetic patients is multifactorial with contributions from hyperglycaemia, impaired vascularization and neuropathy. Foot ulceration is a major complication of diabetes mellitus, which results in significant human suffering and a major burden on healthcare systems.
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