Summary: In an open-label randomised trial, adding sitagliptin to standard care improved healing of diabetic foot ulcers and raised circulating endothelial progenitor cells, apparently independent of glucose lowering, though the shorter healing time did not reach statistical significance.
PICO Summary
| Element | Detail |
|---|---|
| Population | 62 patients with diabetic foot ulcers (31 per group; one lost per group); open-label RCT, China. |
| Intervention | Sitagliptin 100 mg once daily plus standard conventional therapy. |
| Comparison | Standard conventional therapy alone. |
| Outcome | Sitagliptin gave greater reduction in ulcer area and better healing efficacy (p<0.05). Healing time trended shorter but was not significant (p=0.071). CD34+ endothelial progenitor cells and SDF-1α were higher with sitagliptin (p<0.05); HbA1c did not differ. No sitagliptin-related adverse events. |
Sitagliptin for diabetic foot ulcer healing
Open-label RCT · type 2 diabetes · 12 weeks
Adding sitagliptin to standard care raised complete healing of diabetic foot ulcers from 55% to 81% and increased circulating endothelial progenitor cells, with HbA1c unchanged. Small, open-label, and the shorter healing time was not significant.
Expert Commentary
This is an intriguing trial proposing that a familiar oral diabetes drug might do double duty in one of the hardest problems we face, the non-healing diabetic foot ulcer. The mechanistic story is coherent and is the most interesting part: DPP-4 inhibition raises SDF-1α, which mobilises CD34-positive endothelial progenitor cells that support angiogenesis and wound repair, and the trial documented exactly that biological chain alongside better ulcer healing, with HbA1c unchanged, suggesting a glucose-independent effect. I would temper enthusiasm with the study’s real limits. It is small at 62 patients and open-label, which leaves room for assessment bias in wound measurement, and tellingly the healing-time difference only trended toward significance, so the effect, while present on area and efficacy, is not uniformly robust. As with all foot-ulcer work, none of this displaces the fundamentals of offloading, debridement, infection control, and perfusion. Can I use this with my patients? Tentatively. For a patient with diabetes and a stubborn foot ulcer who also needs glycaemic therapy, this offers a rationale to consider sitagliptin for a possible wound-healing bonus, while I treat the evidence as preliminary and keep standard wound care central pending larger, blinded trials.
References
Gao W, Chen D, He H, Jiang N, Chen L, Ran X. Sitagliptin, a DPP-4 inhibitor, effectively promotes the healing of diabetic foot ulcer: a randomized controlled trial. J Diabetes. 2025;17(9):e70156. doi:10.1111/1753-0407.70156