Assessment of healing capacity of glucose-responsive smart gels on the diabetic wound: A comprehensive review

Diabetic wounds provide a substantial therapeutic issue owing to their slow healing and probability of acquiring infections. Conventional wound management approaches generally fail to control these chronic sores successfully. The manufacturing and assessment of innovative materials for wound repair, such as glucose-responsive smart gels, has gained popularity in the past few years. The objective of this review is to understand the challenges, and limitations of conventional treatment for the management of diabetic wounds and to examine the healing capacity of glucose-responsive smart gels and their mechanisms in managing diabetic wounds. The common databases for biomedical and healthcare research were exhaustively searched from 2016 to 2023 viz. PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar. The keywords used for the search are 'hydrogels', 'diabetic wounds', 'diabetic foot ulcer', 'wound healing', and 'smart gels'. For the inclusion of clinical trials and patents, two websites specifically 'clinicaltrials.gov' and 'google patents' were searched with the same keywords. The experimental methodologies utilized in the development of hydrogels and their evaluation were deeply analyzed. The results from studies looking at the effects of glucose-responsive smart gels on wound healing in diabetics that were conducted in vitro and are compiled. Furthermore, clinical relevance and potential challenges associated with the translation of glucose-responsive smart gel-based therapies into diabetic wound care were evaluated. The research gaps were identified and prospective areas to investigate are also elucidated. The articles were selected with both in vitro and in vivo studies for the compilation of recent research investigations specifically hydrogels for diabetic wound care. The smart gels were proven to be glucose-responsive, biocompatible, and demonstrated adequate adhesion to diabetic wounds. The smart gels were found to be self-regulated and undergone high glucose-wound environment triggered drug release owing to their polymer matrices, and enzymes used in their development. The present review marks an encouraging step in the direction of developing novel wound repair treatments customized to the challenges specifically presented by wounds caused by diabetes. Glucose-responsive hydrogels present an intriguing strategy for dealing with the crucial problem of diabetic wound repair, perhaps enhancing the life standard of diabetic patients.