Open Access Research
Effect of comorbidity on the healing time of diabetic foot ulcers treated with honey and hydrogel products
Wael Mahmoud Searan1*
, Yaman Walid Kassab2,3, Mohanad Faris Raheem3, Mohammed A Abdalqader4, Husni Ahmed Al-Goshae5, Hamad Saleh Al-Shubrumi6, Nadeem Sheikh1,7, Muath F. Najjar8
1Diabetic Foot Center, Center Diabetes & Endocrinology, KFSH, Buraidha Al-Qassim, Saudi Arabia
2College of Pharmacy, National University of Science and Technology, Muscat, Oman
3College of Pharmacy, Al-Bayan University, Baghdad, Iraq
4Faculty of Medicine, University of Cyberjaya, Selangor, Malaysia
5Faculty of Medicine, Management and Science University, Shah Alam, Malaysia
6Diabetes and Endocrinology Center, Buraidha Al-Qassim, Saudi Arabia
7Podiatric Clinic Center Diabetes & Endocrinology, KSH, Unaizah Al-Qassim, Saudi Arabia
8Department of Clinical pharmacy, Al-Rayan National College of Health Sciences, Al-Rayan National Colleges, Madinah, Saudi Arabia
*Corresponding author: Wael Mahmoud Searan, Diabetic Foot Center, Diabetes & Endocrinology Center, KFSH, Buraidah Al-Qassim, Saudi Arabia. Tel.: +966-551272175; e-mail: wwwaaas310@gmail.com
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Published: 2026 ; https://doi.org/10.61873/
Abstract
Background: Diabetic foot ulcers (DFUs) are a major complication of diabetes, with healing frequently impaired by systemic comorbidities. Aim: This study, a pre-planned secondary analysis of a randomized controlled trial, examined the influence of nephropathy, cardiovascular disease (CVD), and neuropathy on DFU healing time. Methodology: Data from a prospective, single-blind randomized controlled trial were used. In total, 120 patients with type 2 diabetes and second-degree DFUs (Wagner classification) were allocated to four treatment groups: honey gel alone, hydrogel alone, alternating honey–hydrogel therapy, and Fucidin ointment as the control treatment. Baseline comorbidities and healing time, measured as days to complete epithelialization, were analyzed using t-tests, ANOVA, and Pearson correlation. This analysis did not adjust for treatment group or other confounders. Results: The presence of nephropathy, CVD, and neuropathy was associated with longer healing time. Neuropathy severity showed a significant association with delayed healing. Serum creatinine level showed a positive correlation with healing duration. The cumulative number of comorbidities showed a significant, roughly dose-related association with healing time (p=0.008). Conclusion: Nephropathy, CVD, and neuropathy, as well as a higher cumulative comorbidity burden, were associated with delayed ulcer healing. These findings highlight the need for careful assessment and management of comorbidities during DFU care.
Keywords: diabetic foot ulcer, comorbidity, wound healing time, nephropathy, neuropathy
Please cite as:
Searan W. M., Kassab Y. W., Raheem M. F., Abdalqader M. A., Al-Goshae H. A., Al-Shubrumi H. S., Sheikh N., Najjar M. F.: Effect of comorbidity on the healing time of diabetic foot ulcers treated with honey and hydrogel products. Epitheorese Klin. Farmakol. Farmakokinet. xx(xx): xx-xx (2026). DOI: 10.61873/XXXXXXX
pISSN 1011-6575 • eISSN 2945-1914