A Review on Potential Treatment of Diabetic Foot Ulcers Using Herbal Formulations

Diabetes mellitus represents a rapidly escalating metabolic challenge globally, characterized by chronic hyperglycemia and profound systemic complications. Among these, Diabetic Foot Ulcers (DFUs) emerge as a debilitating microvascular and macrovascular pathology, contributing significantly to patient morbidity, amputation rates, and healthcare expenditures. The pathophysiology of DFUs is multifactorial, involving peripheral neuropathy, ischemia, immune dysfunction, and persistent oxidative stress, which collectively impair tissue regeneration and promote chronic infection. Conventional therapeutic strategies, including glycemic control, surgical debridement, and infection management, often face limitations such as antibiotic resistance, high recurrence rates, and suboptimal healing outcomes. Consequently, there is a critical need for alternative therapeutic paradigms. Phytochemicals and herbal formulations have garnered scientific interest for their pleiotropic effects, offering antioxidant, anti-inflammatory, and antimicrobial benefits that address the complex wound microenvironment. However, the clinical efficacy of crude herbal extracts is frequently hindered by poor bioavailability and instability. Recent advancements in novel drug delivery systems, particularly nanotechnology-based carriers like transferosomes, solid lipid nanoparticles, and hydrogels, present a viable solution to these pharmacokinetic challenges. These advanced systems enhance the solubility, stability, and targeted delivery of bioactive plant compounds, thereby amplifying their therapeutic potential. This review describes the underlying mechanisms of DFU pathogenesis, evaluates the limitations of current standard-of-care treatments, and assesses the role of herbal therapeutics and bioengineered delivery systems in accelerating wound closure and tissue regeneration