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Diabetology
Special Issues
Advances in Diabetic Wound Healing: From Mechanisms to Therapies
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Advances in Diabetic Wound Healing: From Mechanisms to Therapies

A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: 20 January 2027 | Viewed by 3363

Editors

Dr. Catherine S. Wright

E-Mail Website
Guest Editor
Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK
Interests: mechanisms of chronic wound healing in diabetes; fibrosis and gap junction communication; identification of novel therapeutic targets
Prof. Dr. Gordon Ramage

E-Mail Website
Guest Editor
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
Interests: microbiomes and biofilm infections; developing models for the treatment and management of DFUs; AMR
Dr. Steven Patterson

E-Mail Website
Guest Editor
Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK
Interests: novel pharmacological therapies for diabetes, islets biology and hormones; gut hormones and analogues in metabolism, natural products and their antidiabetic properties and potential

Special Issue Information

Dear Colleagues,

The treatment of chronic wounds in diabetes represents a huge clinical challenge, which is ever-increasing. Investigating mechanisms of the development of these wounds, and determining novel therapeutic targets, alongside enhancing current treatments, is key to tackling this huge burden on people with diabetes and their care teams. The modular and cellular mechanism occurring during the initiation and progression of wounds has been advanced by recent research; however, the impairment of healing of chronic wounds is still only partially understood.

Although we understand the effects of diabetic ulcer and diabetic foot disease, and that once a person with diabetes develops one ulcer, they will likely go on to develop more, which goes hand in hand with the length of time that they have been diagnosed with diabetes, treatments are often similar as they have been for many years and progression of treatment options is essential.

To advance the understanding of the pathology and treatment of chronic wounds, particularly diabetic foot ulcers, Diabetology will publish a Special Issue focused on wound healing and tissue repair in diabetes. Potential topics include, but are not limited to, the following:

  • Mechanistic effects of hyperglycaemia on cutaneous cells: fibroblasts, endothelial cells, and keratinocytes;
  • Links between glucose toxicity and senescence of fibroblasts and keratinocytes;
  • Cell signalling and intracellular networks, apoptosis and proliferation in chronic wounds;
  • Animal models of chronic wounds;
  • Molecular markers of wound chronicity or predictors for wound healing;
  • Roles of biofilms in wound failure;
  • Clinical management of chronic infections;
  • Novel approaches to treatment of chronic wounds;
  • Pharmacological interventions to modulate inflammation and proteolysis in diabetic chronic wounds;
  • Clinical trials investigating novel treatments or regimens;
  • Advances in wound dressings to improve healing.

We welcome the submission of Original Research Articles, Reviews, and Systematic Reviews that will advance our understanding and stimulate discussion in this vital field.

Dr. Catherine S. Wright
Prof. Dr. Gordon Ramage
Dr. Steven Patterson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diabetology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ulcer
  • chronic
  • wound
  • healing
  • fibroblasts
  • keratinocytes
  • skin
  • biofilms
  • treatment
  • therapies
  • hyperglycaemia
  • glucose
  • diabetes
  • infection

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  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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15 pages, 1854 KB  
Article
Can a Chatbot Help Heal a Wound? Context-Aware Prompts for Boosting Adherence in Diabetic Foot Ulcers
by Aria Rabet, Aminreza Khandan, Arian Rabet, Mohammad Dehghan Rouzi, Fabiola Rodriguez, Adriana Garibay, David G. Armstrong and Bijan Najafi
Diabetology 2026, 7(5), 96; https://doi.org/10.3390/diabetology7050096 - 12 May 2026
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Abstract
Background: Smart offloading technologies enable the real-time, objective monitoring of adherence in patients with diabetic foot ulcers (DFUs). Although remote tracking may reinforce adherence and improve wound healing, effectiveness depends on sustained device use, particularly as devices are often removed during rest periods. [...] Read more.
Background: Smart offloading technologies enable the real-time, objective monitoring of adherence in patients with diabetic foot ulcers (DFUs). Although remote tracking may reinforce adherence and improve wound healing, effectiveness depends on sustained device use, particularly as devices are often removed during rest periods. Real-time, behavior-contingent feedback informed by sensor data, including AI-supported messaging capable of detecting nonadherence, may enhance reinforcement. However, the feasibility and behavioral impact of such strategies remain unclear. Methods: We conducted a prospective feasibility case series nested within a larger DFU cohort of 210 participants, enrolling eight adults with active DFUs. Participants used a sensor-integrated offloading device paired with a smartwatch (SmartBoot) and a mobile application (CORA) that delivered notifications to their smartphones. Notifications were either schedule-based or context-aware, using real-time SmartBoot data to generate personalized messages. The primary outcome was a sensor-detected transition from nonadherent to adherent offloading within 60 min. Results: A total of 130 notifications were delivered, with 125 included in the behavioral response analysis. Context-aware notifications demonstrated higher transition rates than schedule-based notifications. Adaptive Reinforcement yielded the highest response rate (77.4%, 24/31), followed by Clinical Course Correction (71.4%, 20/28), whereas Safety and Technical Assurance (40.7%, 11/27) and Motivational Coaching (30.8%, 12/39) showed lower response rates. Conclusions: Real-time, context-aware feedback is feasible and associated with improved short-term adherence, supporting evaluation in larger trials. Full article
(This article belongs to the Special Issue Advances in Diabetic Wound Healing: From Mechanisms to Therapies)
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14 pages, 1630 KB  
Article
Photodynamic Therapy as an Adjunctive Approach for Diabetic Foot Osteomyelitis: A Prospective Case Series
by João Antonio Correa, Sofia Torres Velloso, Luciene do Nascimento Lima, Patricia Paola Cagol, Julia Yamanaka Agnelo, Gustavo Lolli, João Paulo Tardivo, Rafael Carvalho de Vilhena Furst, Gabriela Tessaro Cremoneis and Rodrigo Daminello Raimundo
Diabetology 2026, 7(5), 88; https://doi.org/10.3390/diabetology7050088 - 2 May 2026
Viewed by 1048
Abstract
Introduction: Type 2 diabetes mellitus predisposes patients to neuropathy, peripheral arterial disease, and diabetic foot ulcers, which may become infected and progress to osteomyelitis, increasing the risk of amputation. The growing prevalence of multidrug-resistant organisms complicates management. Photodynamic therapy (PDT), which combines a [...] Read more.
Introduction: Type 2 diabetes mellitus predisposes patients to neuropathy, peripheral arterial disease, and diabetic foot ulcers, which may become infected and progress to osteomyelitis, increasing the risk of amputation. The growing prevalence of multidrug-resistant organisms complicates management. Photodynamic therapy (PDT), which combines a photosensitizer with light-emitting diode irradiation to generate reactive oxygen species, has emerged as a potential adjunctive antimicrobial strategy without inducing resistance. Objective: To describe clinical outcomes observed in patients with diabetic foot osteomyelitis treated with adjunctive photodynamic therapy (PDT), with emphasis on wound evolution, limb preservation, and healing time. Methods: This prospective case series included patients with osteomyelitis secondary to infected diabetic foot ulcers treated at a university hospital. Demographic and clinical data were collected from medical records. Serial photographic documentation was used to monitor wound progression and tissue response during therapy. Results: Sixteen patients with diabetic foot osteomyelitis were included. Complete healing was achieved in 13 patients (81.25%), while 2 patients (12.5%) remained under treatment with partial healing and 1 (6.25%) underwent major amputation. Among healed patients, healing time ranged from 19 to 546 days, with a median of 118 days. The number of photodynamic therapy sessions ranged from 2 to 12, depending on the clinical course of each case. Healing time varied among patients, and the hallux was the most frequent site of osteomyelitis. During follow-up, only one patient underwent major amputation, whereas the remaining patients either achieved complete healing or were still under treatment at the time of analysis. Healing time was comparable between insulin-dependent and non-insulin-dependent diabetes, although numerically shorter in the latter. Longer healing periods were associated with more treatment sessions. Conclusions: In this prospective uncontrolled case series, adjunctive PDT was associated with favorable clinical evolution in a subset of patients with diabetic foot osteomyelitis. However, because of the small sample size and the absence of a control group, these findings should be considered preliminary and hypothesis-generating. Full article
(This article belongs to the Special Issue Advances in Diabetic Wound Healing: From Mechanisms to Therapies)
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Review

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27 pages, 8079 KB  
Review
Comparative Certainty of Evidence for Diabetic Foot Ulcer Therapies: A Narrative Synthesis
by Stephanie M. Mueller, Hannah D. Shi, Aditi Kaveti, Amy Du, Devin J. Clegg, Romi Wagner and Dennis P. Orgill
Diabetology 2026, 7(7), 131; https://doi.org/10.3390/diabetology7070131 - 7 Jul 2026
Viewed by 331
Abstract
Background: Diabetic foot ulcers (DFUs) are a major cause of morbidity and lower extremity amputation. Numerous advanced wound therapies with various mechanisms of action have been developed to improve healing outcomes; however, the comparative certainty of evidence supporting these interventions remains unclear. [...] Read more.
Background: Diabetic foot ulcers (DFUs) are a major cause of morbidity and lower extremity amputation. Numerous advanced wound therapies with various mechanisms of action have been developed to improve healing outcomes; however, the comparative certainty of evidence supporting these interventions remains unclear. This study evaluates randomized controlled trials (RCTs) of DFU therapies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Methods: A narrative synthesis of RCTs published between January 2016-January 2026 evaluating therapies for DFUs was performed. For studies that reported 12–week healing outcomes, risk of bias was assessed using the Cochrane Risk of Bias 2 tool and certainty of evidence for each therapy subgroup was evaluated using the GRADE framework. Results: A total of 143 RCTs were included with 45 RCTs undergoing GRADE assessment. The proportion of studies demonstrating statistically significant improvements in 12-week healing rates relative to controls varied and was not reflected in the GRADE assessment. Moderate-certainty evidence was assigned to the hyperbaric oxygen therapy subgroup. Low-certainty evidence was assigned to silver dressings, biosynthetic scaffolds, stem cell therapy, and negative pressure wound therapy. Very low-certainty evidence was assigned to topical oxygen, synthetic structural scaffolds, moisture-retaining dressings, local antimicrobial delivery, placental-derived skin substitutes, platelet-rich plasma, acellular dermal matrices, allografts/xenografts, and off-loading devices. No therapy subgroup was assigned high-certainty evidence. Conclusions: The certainty of evidence supporting DFU therapies varies substantially across intervention categories. These findings highlight the need for larger, methodologically rigorous comparative trials to clarify the effectiveness of DFU therapies and guide evidence-based wound care. Full article
(This article belongs to the Special Issue Advances in Diabetic Wound Healing: From Mechanisms to Therapies)
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