Diabetic foot ulcers (DFUs) remain one of the most persistent and challenging complications associated with long-term diabetes. Despite improvements in diabetes management, DFUs continue to be a major cause of infection, repeated hospital visits, and lower-limb amputation across the globe. Traditional treatments often focus on controlling symptoms and preventing infection, yet many ulcers fail to heal fully or recur after temporary improvement. As a result, regenerative medicine—particularly therapy using umbilical cord–derived mesenchymal stem cells (UC-MSCs)—has attracted growing interest in Thailand for its potential to support true tissue repair.
Why Diabetic Foot Ulcers Resist Healing
- Peripheral Arterial Disease (PAD): Reduced blood flow in the legs and feet deprives tissues of oxygen and essential nutrients, slowing cell growth and preventing effective wound
- Peripheral Neuropathy: Nerve damage caused by prolonged high blood sugar diminishes sensation in the feet, allowing small injuries to go unnoticed. Without intervention, these minor issues can expand into deep ulcers.
- Compromised Immune Response: High glucose levels weaken immune function and make individuals more prone to infections.
- Persistent Inflammation: Many diabetic ulcers remain stuck in a prolonged inflammatory state.
- Mechanical Pressure: Repeated friction, poor footwear, or limited mobility places continuous stress on vulnerable areas. This repeated trauma interferes with wound closure and contributes to ulcer
The Promise of Stem Cell Therapy
Stem cell therapy offers a regenerative approach that differs significantly from conventional DFU treatments. Instead of simply covering or managing the wound, mesenchymal stem cells actively support the repair and renewal of damaged tissues. MSCs have the ability to differentiate into several cell types relevant to skin and vascular healing, including fibroblasts, endothelial cells, and keratinocytes. They also release a diverse mix of growth factors and signaling molecules that promote cellular repair and regulate inflammation.
When applied to DFUs, MSCs can:
- Stimulate the formation of new tissue and collagen
- Support the growth of new blood vessels
- Reduce excessive inflammation
- Aid in nerve repair and improve sensation
- Enhance overall wound stability
Among various types of stem cells, those derived from umbilical cord tissue stand out for their strong regenerative activity, low immunogenicity, and ability to be used without invasive harvesting procedures.
How UC-MSCs Support Wound Healing
- Enhancing Circulation Through Angiogenesis: UC-MSCs release vascular endothelial growth factor and similar molecules that encourage the growth of new capillaries around the wound. These new vessels supply oxygen and nutrients that are essential for tissue regeneration, especially in individuals with poor circulation.
- Regulating Inflammation: Chronic inflammation is a major barrier to healing in diabetic ulcers. UC-MSCs help shift the wound environment from a destructive state to one that favors repair by releasing anti-inflammatory cytokines and guiding immune cells toward a healing-focused response.
- Rebuilding Skin and Soft Tissue: These stem cells can evolve into fibroblasts and keratinocytes—cells necessary for forming new skin layers and supporting connective tissue. They also help increase collagen production, which strengthens the repaired tissue and enhances long-term stability.
- Supporting Extracellular Matrix Remodeling: The extracellular matrix acts as the structural framework for new cell growth. UC-MSCs help organize and repair this matrix, providing a more supportive environment for cell migration and wound closure.
- Promoting Nerve Regeneration: Diabetic neuropathy contributes heavily to ulcer formation and recurrence. UC-MSCs secrete factors that nourish nerve cells and encourage regrowth of damaged nerve fibers, which may improve sensation and help prevent reinjury.
- Offering Antimicrobial Support: Some studies suggest that MSCs can produce antimicrobial peptides that help control bacterial activity. This is particularly valuable in DFUs, which are prone to infection.
Clinical Outcomes Observed in Stem Cell Therapy
- Faster Wound Closure: Many patients show accelerated healing, with ulcers shrinking or closing more rapidly than expected with traditional treatments alone.
- Improved Blood Flow: Diagnostic assessments often reveal better circulation and evidence of new vessel formation after treatment.
- Reduced Amputation Risk: In severe cases, stem cell therapy has helped preserve limbs that might otherwise have required partial or full amputation.
- Pain Reduction: Decreased inflammation and improved tissue repair often lead to reduced discomfort and better mobility.
- Better Tissue Quality: Post-treatment tissue samples typically show more organized collagen, increased vascularity, and healthier overall structure.
Benefits of UC-MSC Therapy for DFUs
- Addresses Core Causes: By targeting inflammation, poor circulation, and tissue loss, the therapy approaches DFUs at their root rather than treating symptoms alone.
- Minimally Invasive: The treatment usually involves localized injections or topical application, avoiding major surgical procedures.
- Works With Standard Care: UC-MSCs can be combined with routine wound management strategies such as off-loading, dressings, antibiotics, and debridement.
- Supports True Regeneration: Instead of simply covering the wound, stem cells help rebuild deeper layers and restore functional tissue.
- Improves Quality of Life: Faster healing and reduced pain support better mobility, independence, and emotional well-being.
Thailand’s Role in Advancing Regenerative Medicine
Thailand has become a recognized center for regenerative medicine in the region. The country’s healthcare system includes advanced laboratories, experienced clinicians, and regulated stem cell programs that support ongoing research. Hospitals and medical centers in major cities have been exploring UC-MSC therapy as part of their efforts to improve outcomes for patients with chronic wounds, including diabetic ulcers. Thailand’s established position in medical tourism also means that individuals from various parts of the world seek treatment there, contributing to continued clinical experience and development.
Conclusion
UC-MSC therapy offers a promising new direction in the management of diabetic foot ulcers. By supporting angiogenesis, regulating inflammation, rebuilding tissue, and encouraging nerve repair, these stem cells address the core biological challenges that make DFUs so difficult to treat. Evidence from clinical practice in Thailand and other regions shows meaningful improvements in healing speed, tissue quality, and limb preservation. As research progresses and treatment techniques evolve, UC-MSC therapy may become a key component of comprehensive care for chronic diabetic wounds. For many patients, this approach offers not only improved healing but also renewed mobility, comfort, and confidence.