Can Stem Cell Therapy Heal Diabetic Foot Ulcers?

Key details

• High amputation risk: Diabetic foot ulcers are a serious complication of diabetes, often leading to infection and significantly higher amputation risks compared to the non-diabetic population.
• Treating the root cause: Unlike standard care, stem cell therapies target the underlying causes of ulcers by promoting blood flow, reducing inflammation, and regulating immune responses.
• Efficacy: Research indicates that stem cell improves healing rates and decreases amputation rates compared to conventional treatments.
• Source matters: While bone marrow and fat tissue are common sources of stem cells, umbilical cord stem cells offer superior self-renewal abilities and are easily collected at birth.

What are diabetic foot ulcers and why are they dangerous?

Diabetic foot ulcers are chronic wounds caused by a combination of nerve damage (neuropathy) and restricted blood supply, which can lead to severe infection and tissue death.

Because diabetic neuropathy causes loss of sensation in the legs and feet, small nicks and wounds frequently go unnoticed and untreated, leading them to ulcerate or become infected. Simultaneously, damage to blood vessels restricts the blood supply, meaning the feet receive fewer infection-fighting cells, causing wounds to heal slowly and potentially become gangrenous.[1][2]

The statistics regarding this condition are stark:

• Prevalence: Up to one third of people with diabetes will develop a foot ulcer during their lifetime.[3]
• Amputation risk: The risk of leg, foot, or toe amputation for people with diabetes is more than 20 times that of people without diabetes. Up to 28% of diabetic foot ulcers could result in some form of amputation.[1]
• Mortality: Post-amputation survival rates are low, with only 50% of patients surviving two years after the procedure. Even without an amputation, only 56% of diabetic patients who have had foot ulcers survive for five years.[1]

How are diabetic foot ulcers currently treated?

Current treatment for diabetic foot ulcers focuses mainly on symptom management, involving wound care, offloading pressure, and infection control.

Standard protocols include dressings, antibiotics, compression clothes, and keeping weight off the foot using orthotics, special footwear, or wheelchairs. More invasive treatment, including debridement (surgical removal of infected tissue), may also be necessary.[4][5]

However, these therapies often fail to achieve complete healing. Only two thirds of diabetic foot ulcers eventually heal without surgery.[1]

How does stem cell therapy help heal diabetic ulcers?

Therapies based on mesenchymal stem cells (MSCs) have the potential to help treat the root cause of diabetic foot ulcers, thanks to these cells’ ability to suppress abnormal immune responses and reduce inflammation, promote the development of new blood vessels (angiogenesis), and recruit immune cells to the site of injury.

This multifaceted potential makes MSC therapies uniquely suited to the healing of diabetic foot ulcers by effectively addressing the root causes of the problem – poor circulation, inflammation, and insufficient or abnormal immune responses – which is something where currently available treatment fails.[6]

Preliminary studies and trials have been investigating this potential, with generally positive results. A 2022 review, pooling data from 14 studies, found that stem cell therapy was more effective than conventional treatment in several key areas:

• Improved healing: better healing rates and improvement in blood flow.
• Pain reduction: improvements in pain-free walking distance and level of pain at rest.
• Limb preservation: A significant decrease in amputation rate.[7]

What challenges remain for widespread clinical use?

Despite encouraging results, challenges such as patient variability and the need for standardized data prevent the treatment from being ready for widespread use immediately.

Small differences between patients – their age, how well their diabetes is controlled, vascular disease, and the microorganisms inhabiting the ulcer – can have an impact on how the treatment works. This makes it complicated to assemble a single set of coherent, standardised data from multiple small-scale trials. Thus, larger-scale trials with a lengthy follow-up period will be required to ensure the treatment is effective and remains so long-term.[6]

Which types of stem cells are effective for treating diabetic foot ulcers?

Research currently focuses on Mesenchymal Stem Cells (MSCs) derived from bone marrow, adipose (fat) tissue, or umbilical cord blood, though each source presents different advantages and challenges.

• Bone Marrow MSCs: They have an established clinical track record and show strong potential for vascular regeneration. However, they require invasive collection procedures. Furthermore, their regenerative potential may be impaired by the donor’s age, as well as, in the case of autologous (using the patient’s own cells) therapies, by abnormal bone marrow microenvironment caused by diabetes.
• Adipose (Fat) MSCs: They are easy to collect and expand in vitro. Research has found that they can promote wound healing, reduce inflammation, and improve tissue regeneration. However, their function can be compromised by the patient’s weight. Diabetes-related lipotoxicity (fat accumulation in organs) can also reduce these cells’ ability to migrate to the wound site. There are also concerns about long-term complications.
• Umbilical Cord MSCs: These cells have high self-renewal abilities, strong immunoregulatory functions, and can promote angiogenesis and reduce infection risk.[6] However, access to them is limited by the fact that they can only be collected immediately after birth.

How can parents ensure their child has access to future stem cell treatments?

Any autologous stem cell treatment using umbilical cord stem cells, for diabetic foot ulcers or otherwise, might only be accessible to people whose parents chose to store their umbilical cord blood at birth.

To learn more about how you could do this for your baby, giving them the greatest chance to access to these powerful stem cells for potential future treatments, fill in the form below to request our free guide.

References

[1] Kerr, M. (2012). Foot Care for People with Diabetes: The Economic Case for Change. https://www.diabetes.org.uk/sites/default/files/migration/pdf/footcare-for-people-with-diabetes.pdf

[2] NHS (2022). Complications – Peripheral neuropathy. https://www.nhs.uk/conditions/peripheral-neuropathy/complications/

[3] Akkus, G. and Sert, M. (2022). Diabetic foot ulcers: A devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities. World Journal of Diabetes, 13(12), pp.1106–1121. doi:https://doi.org/10.4239/wjd.v13.i12.1106

[4] Cleveland Clinic (2022). Foot and toe ulcers: Treatment, prevention, repair & causes. https://my.clevelandclinic.org/health/symptoms/17169-foot-and-toe-ulcers

[5] NHS Northern England. Diabetes – Foot Ulcers. https://www.england.nhs.uk/north-east-yorkshire/wp-content/uploads/sites/49/2019/07/foot-ulcer-information-guide.pdf

[6] Wang, B., Zhao, G., Zhang, J., Chen, W., Yang, S. and Sun, Y. (2025). Advances in Stem Cell Therapy for Diabetic Foot Ulcers. Diabetes, Metabolic Syndrome and Obesity, Volume 18, pp.4021–4034. doi:https://doi.org/10.2147/dmso.s564011

[7] Sun, Y., Zhao, J., Zhang, L., Li, Z. and Lei, S. (2022). Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update. Stem Cell Research & Therapy, 13(1). doi:https://doi.org/10.1186/s13287-022-03110-9