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©The Author(s) 2023.
World J Diabetes. Jun 15, 2023; 14(6): 930-938
Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.930
Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.930
Ref. | Country | Aim | Study design | Subject groups (number) | Insulin type and dose | Results |
Nakamura et al[13], 2003 | Japan | To study the effect of the combination of FGLM-NH2 and IGF-1 on corneal epithelial wound healing in rats with diabetes | Animal | 4-wk-old male Sprague-Dawley Streptozocin-induced diabetic rats; 100 g (n = 20) | FGLM-NH2 (1 mmol/L) and IGF-1 (1 μg/mL) 6 times per day | Similar wound healing processes were observed in normal rats and diabetic rats treated with FGLM-NH2 and IGF-1. Wound closure was significantly faster in diabetic rats treated with FGLM-NH2 and IGF-1 than in those treated with vehicle |
Zagon et al[14], 2007 | United States | To determine TI normalizes delayed corneal wound healing in rats with diabetes | Animal | Male Sprague-Dawley Streptozocin-induced diabetic rats; 165 g (38 diabetic rats; 11 nondiabetic rats) | Bovine insulin 1, 2, or 5 U. Single drop (20 μL) | TI normalizes corneal re-epithelialization in diabetic rats. No difference in efficacy of insulin dose of 1, 2, or 5 U and safe for cornea |
Chen et al[15], 2013 | United States | To determine corneal nerve depletion in type 1 diabetes rats using corneal confocal microscopy and its relationship with TI | Animal | Female Swiss Webster Streptozocin-induced diabetic mice; 25-30 g (8 diabetic mice; 8 control) | 0.1 IU of regular U-100 Humulin (Lilly, Indianapolis, IN, United States) in 10 μL saline | TI prevent depletion of nerve occupancy in the subbasal nerve plexus of the cornea without affecting systemic glycemic control |
Yang et al[10], 2020 | China | To investigate the relationship between TI and WnT/β-catenin signaling pathway in corneal epithelial healing and corneal nerve repair in diabetic mice | Animal | Streptozocin-induced diabetic mice (6 to 8-year-old-male C57BL/6J mice) | Human neural insulin (Lilly France S.A., Fegersheim, France). 3 μL QID (1 IU/mL) | Insulin contributes to diabetic corneal epithelial wound healing and nerve injury healing via Wnt signaling, making it a potential protective factor for diabetic corneal epithelial wounds and nerve injuries |
Ref. | Country | Aim | Study design | Subject groups (number) | Insulin type and dose | Results |
Bastion and Ling[16], 2003 | Malaysia | To determine whether TI improve healing rate of corneal epithelial erosion during vitreoretinal surgery | Retrospective review | Human (15 eyes of 14 patients underwent corneal debridement during vitreoretinal surgery) | Actrapid HM, Novo Nordisk 1 U QID (50 UI/mL) | Delayed epithelial healing in diabetic eyes compared with normal eyes. Diabetic eyes treated with TI had significantly smaller defect size than diabetic eyes treated with conventional therapy |
Fai et al[3], 2017 | Malaysia | To investigate the effect of 3 concentration of TI in corneal epithelial wound healing in postoperative patient with diabetes | Double blind randomized controlled | Human (32 eyes of 32 diabetic patient underwent corneal debridement during vitreoretinal surgery) | Actrapid HM, Novonordisk 0.5, 1, 2 U QID | TI 0.5 U QID is most effective for corneal re-epithelialization in patients with diabetes after vitrectomy surgery as compared with placebo and higher concentrations. TI is safe for human ocular use |
Aniah Azmi and Bastion[17], 2020 | Malaysia | To determine the short-term effects of TI on symptoms and signs of dry eye disease in patients with diabetes | Randomized, double-blind interventional study | Human (320 eyes of 160 patients with diabetes for treatment of dry eyes) | Actrapid HM, Novo Nordisk 1 U QID (25 UL/mL) | Similar improvement in the Ocular Surface Disease Index score for TI 1 U QID and standard artificial tears in the treatment of dry eye in patients with diabetes |
Quiroz-Mendoza et al[18], 2021 | Mexico | To compare the effect of TI and sodium hyaluronate in epithelial defects postoperative in patients with diabetes | Controlled human clinical trial | Human (36 eyes of 36 patients with diabetes who underwent corneal debridement during vitreoretinal surgery) | Recombinant human insulin (Humulin® R, Eli Lilly and Company, Indiana, United States) 0.5 IU/drop QID (25 IU/mL) | TI 0.5 IU/drops monotherapy and combined treatment with 0.15% sodium hyaluronate is effective in healing corneal epithelial defects after intraoperative corneal debridement in patients with diabetes. Adding sodium hyaluronate to TI did not provide additional benefit |
- Citation: Leong CY, Naffi AA, Wan Abdul Halim WH, Bastion MLC. Usage of topical insulin for the treatment of diabetic keratopathy, including corneal epithelial defects. World J Diabetes 2023; 14(6): 930-938
- URL: https://www.wjgnet.com/1948-9358/full/v14/i6/930.htm
- DOI: https://dx.doi.org/10.4239/wjd.v14.i6.930