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Review
. 2025 Jan 7;17(1):9.
doi: 10.1186/s13098-024-01523-5.

Therapeutic potential of adipose-derived stem cells for diabetic foot ulcers: a systematic review and meta-analysis

Mohamed A Abu Elainein  1 , Mohamad Mahmoud Whdan  1 , Mahmoud Samir  1 , Nada G Hamam  2 , Mohamed Mansour  1 , Mohamed Abdel Mohsen Mohamed  1 , Mahmoud Mostafa Snosy  1 , Mahmoud Ayman Othman  1 , Ahmed Sayed Sobieh  1 , Mahmoud Gamal Saad  1 , Mohamed A Labna  1 , Salma Allam  3
Affiliations
Review

Therapeutic potential of adipose-derived stem cells for diabetic foot ulcers: a systematic review and meta-analysis

Mohamed A Abu Elainein et al. Diabetol Metab Syndr. .

Abstract

Background: As the global prevalence of diabetes mellitus increases, the incidence of non-healing wounds in diabetic patients is expected to rise significantly, according to the International Diabetes Federation (IDF), around 537 million adults currently suffer from diabetes mellitus worldwide and 20% to 30% of individuals with diabetes are hospitalized due to diabetic foot ulcers. Conventional treatments such as traditional dressings often fall short in ensuring satisfactory wound healing, this Meta-analysis investigates the therapeutic potential of Adipose-derived Stem Cells (ADSCs) as a promising strategy for addressing this challenge.

Aims: To Assess the Therapeutic Potential of Adipose-Derived Stem Cells for Managing Diabetic Foot Ulcers compared to conventional lines of treatments.

Methods: The PubMed, SCOPUS, Web of Science Core Collection, Cochrane Library, and ClinicalTrials.gov. databases were searched from January 2000 and December 2023, articles were primarily evaluated regarding their titles and abstracts, then full-text screening was assessed against the inclusion and exclusion criteria by utilizing Rayyan software. The Cochrane risk of bias (RoB 2) assessment tool was used to identify the risk of bias in our included studies. A statistical analysis was performed using Review Manager (RevMan) Version 5 software. Dichotomous data was subjected to risk ratio analysis, while continuous data underwent Mean Difference (MD) evaluation, all was reported with 95% confidence intervals, P value is considered statistically significant if less than 0.05.

Results: Regarding the total healing state, five studies reported that more participants healed completely at the end of the follow-up period in the ADSCs group (Risk ratio = 1.56, 95% CI [1.32, 1.86], P < 0.00001), for the healing rate the overall effect estimate favors the ADSCs group (pooled effect estimate = 1.84, 95% CI [1.51, 2.89], P < 0.00001), and regarding the healing time the pooled mean difference of the studies demonstrated that the ADSCs group required fewer days to heal than the standard care group. (pooled mean difference = -19.33, 95% CI [-37.36, -1.29], P = 0.04).

Conclusion: ADSCs provide favorable healing results and safety compared to standard care for diabetic foot ulcers.

Keywords: Adipose stem cells; Diabetes; Diabetic foot ulcers; Regenerative medicine; Stem cells.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart
Fig. 2
Fig. 2
Risk of bias summary and graph of the six included studies based on the Cochrane risk of bias assessment tool (ROB 2 tool)
Fig. 3
Fig. 3
Comparison of the Total Healing State between the ADSCs group and the Standard care group at the end of follow-up period
Fig. 4
Fig. 4
Comparison of the Healing Rate between the ADSCs group and the Standard care group at the end of follow-up
Fig. 5
Fig. 5
Comparison of the Healing Rate between the ADSCs group and the Standard care group at different follow-up points (3 weeks, 4 weeks, 6 weeks, 2 months)
Fig. 6
Fig. 6
Comparison of the Total Healing Time (days) between the ADSCs group and the Standard care group
Fig. 7
Fig. 7
Comparison of the Total Healing Time (days) between age-based subgroups of the ADSCs group and the Standard care group
See this image and copyright information in PMC

References

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