Extraordinary Rapid Wound Healing Time in Diabetic patients treated with Microburst Insulin Infusion

Abstract

Importance: Non-healing diabetic ulcerations of the foot lead to amputations and premature mortality. Microburst Insulin Infusion has demonstrated an ability to accelerate healing in otherwise non-healing wounds. Objective: To demonstrate the benefit of adding Microburst Insulin Infusion to conventional diabetic wound care to significantly decrease wound healing time. Methods: A case series of five patients received Microburst Insulin Infusion therapy for significant peripheral diabetic ulcerations after failing conventional wound care. These five cases were treated from 4 independent Microburst Insulin Infusion clinics. Four of the wounds exceeded 6 cm². Patient charts were reviewed and relevant data was collected. All individuals in this manuscript have given written informed consent to publish these case details. Setting: Multicenter referral clinics providing Microburst Insulin Infusion Therapy Exposure: Microburst Insulin Infusion is an adjunctive treatment to conventional diabetic therapy performed in an outpatient clinic setting. A weight based oral glucose dose is administered while pulsatile intravenous insulin is delivered by the Bionica Microdose pump. The treatment is comprised of three 1 hour sessions and occurs up to five times a week, when the patient presents with un-healing wounds. Main Outcomes and Measures: Time to wound healing. A secondary outcome was failure of wound healing. Hypothesis for this study was formulated post treatment. Results: A significant decrease in wound healing time was observed when utilizing Microburst Insulin Infusion. The mean time to complete healing was 84.2 days compared to 133 days in published literature(1). The patient with a foot wound measuring an amazing 228.6 cm² healed in 102 days and amputation was not necessary. There were no treatment failures in this small series. As a result of decreased healing time, there was an absence of infection and no amputations were required for these wounds. Conclusion and Relevance: The addition of Microburst Insulin Infusion therapy resulted in a shortening of the time to healing by 49 days (7 weeks) for patients with poor response to conventional wound care. This is a 37% reduction in the time to heal thus reducing risk of infection and additional healthcare costs. The mechanism of action of Microburst Insulin Infusion in healing diabetic wounds is still unclear, but may involve an improved cellular metabolism, decreased inflammation and increased levels of Nitric oxide that enhance peripheral vascular supply and tissue healing.