A combinatorial strategy for diabetes associated co-morbidities

According to the international diabetes federation as of 2021 approximately 537 million people suffer from diabetes, of which, 75 million comprises the Indian population. This epidemic of diabetes has far reaching sequelae, the most prevalent of which is the degeneration of the nervous system, known as diabetic neuropathy, of which, Diabetic Peripheral Neuropathy (DPN) is the most common. The desensitization of the nerves leads to further trauma causing complications such as diabetic foot ulcers, which are prone to infections. These infections, if untreated, act as a contiguous source for diabetic osteomyelitis causing further economic distress by these additional complications, and may even lead to amputations. Yet, efficient disease-modifying treatments is still a lacuna in diabetic therapy. Current therapy focuses on early diagnosis, glycemic control, and management of the complications according to the symptoms. However, this strategy is ineffective in restoring the already damaged tissues warranting additional approaches. Regenerative therapies have the potential to address the delayed wound healing along with impaired neuro-vascularization. Using the current biomaterial-based techniques we aim to provide the required bioactive and electroactive cues in a holistic strategy which addresses the underlying neuropathy while healing the ulcer and acts as a localized treatment for diabetic osteomyelitis.