Treatment with topical nitroglycerine may promote the healing process of diabetic foot ulcers

Diabetes mellitus is one of the main problems of the health care systems of all societies. A vast number of
diabetic patients suffer from diabetic foot ulcers (DFUs) some of which may lead to the amputation of the
organ(s). Nitric oxide (NO) is an indigenous gas that is produced at various sites in the body and has been
shown to possess important roles in wound healing. Previous studies have shown that not only is the
production of NO decreased in diabetic patients but also the sensitivity of the cells of such patients to
NO is dramatically reduced. Nitroglycerine (isosorbide dinitrate) can be employed as an effective donor
of NO to diabetic wounds. On such a basis, we suggest a novel hypothesis that delivery of compensatory
amounts of NO to the ulcers by the administration of topical nitroglycerine enhances blood flow and
biochemical activity of the ulcers and thus promotes wound healing.