Summary: In a randomised trial in type 2 diabetes with Wagner grade 1–2 foot ulcers, daily topical ozonated olive oil improved wound healing, quality of life, glycaemic control, and one inflammation marker, although the lipid profile and the cytokines IL-6 and TNF-α did not change.
PICO Summary
| Element | Detail |
|---|---|
| Population | 123 adults (18–75) with type 2 diabetes and Wagner grade 1–2 foot ulcers; single-centre RCT, Iran. |
| Intervention | Daily topical ozonated olive oil (5 mL, 50 g/m³) for 4 weeks (n=62). |
| Comparison | Standard wound care (debridement, dressings, offloading) without ozonated oil (n=61). |
| Outcome | Better wound healing on the Bates-Jensen tool (p<0.001), improved diabetes quality of life (p<0.001), lower HbA1c (7.1% vs 7.7%; p=0.005), lower fasting and postprandial glucose, and lower hs-CRP (p=0.006). IL-6, TNF-α, and lipid profile did not change significantly despite the trial’s title. No adverse effects. |
Ozonated Olive Oil for Diabetic Foot Ulcers
RCT · type 2 diabetes · 4 weeks
Topical ozonated olive oil improved diabetic foot ulcer healing, quality of life, and glycaemic control over four weeks. Lipids and IL-6/TNF-α were unchanged, so it is best framed as a low-risk adjunct to standard care.
Expert Commentary
This is a reasonably encouraging adjunct trial that should be read with attention to which outcomes actually moved, because the title oversells the lipid story. The wound-healing signal is the most credible part, measured objectively with the Bates-Jensen tool and accompanied by better patient-reported quality of life, and the rationale is plausible since ozone has antimicrobial and tissue-oxygenation effects relevant to a hypoxic, often colonised diabetic wound. The accompanying fall in HbA1c from a topical therapy is intriguing and best understood indirectly, as healing a chronic wound reduces the inflammatory and infective burden that aggravates insulin resistance, consistent with the drop in hs-CRP. But the inflammatory effect was selective, with IL-6 and TNF-α unchanged, and the lipid profile flagged in the title did not improve, so I would not claim a lipid benefit. The limits are a short four weeks, only superficial ulcers, a single centre, and no amputation or recurrence data. Can I use this with my patients? Yes, as a low-risk add-on. For a superficial diabetic foot ulcer progressing slowly on good standard care, ozonated olive oil is a reasonable inexpensive adjunct, provided offloading, debridement, infection control, and perfusion remain the foundation.
References
Vahedi S, Rahimi M, Shad TS, Khanchemehr Y, Ghoozlu KJ, Fallah S, Moradi M. Effects of topical ozonated olive oil on lipid profile, quality of life, wound healing and glycemic control in patients with diabetic foot ulcers: a randomized controlled trial. Lipids Health Dis. 2025;24(1):291. doi:10.1186/s12944-025-02726-z