A treatment called maggot debridement therapy (MDT) could enhance diabetes wound healing, according to a new review.
MDT is used in the UK for the treatment for diabetic foot ulcers and has been shown to be cost-effective.

Foot ulcers can affect people with type 1 diabetes and type 2 diabetes, and up to 10 per cent of people with diabetes will develop a foot ulcer at some point.
How does MDT work?
The maggots are modified fly larvae which eat dead flesh and kill microbes. They also disinfect the area through the release of antimicrobial compounds.
These sterile, lab-raised larva of the green bottle fly Lucilia secricata are applied to wounds such as diabetic foot ulcers, which struggle to heal properly.
Researchers from North Carolina State University (NCSU), US and Massey University, New Zealand investigated if the healing process could be actively sped up. This could therefore shorten the time it takes for wounds to heal.
The maggots were genetically engineered to produce and release a hormone, a human growth factor, which actively stimulates cell growth and wound healing.
Green bottle fly larvae were modified to produce and secrete human platelet-derived growth factor (PDGF-BB) in response to a trigger. Because it can stimulate cell growth and promote wound healing, PDGF-BB has previously been investigated as a treatment for non-healing wounds.
Potential for clinical use
The maggots were engineered to only make PDGF-BB if they were raised on a diet that lacked the antibiotic tetracycline. This led to high levels of the growth factor being produced and showed potential for clinical use.
“Our system could potentially be used to deliver a variety of growth factors and anti-microbial peptides to the wound environment with the aim of enhancing wound healing, thereby improving patient outcome in a cost-effective manner,” the authors wrote.
Professor Max Scott, professor of entomology at NCSU, added that MDT could provide an affordable treatment to people with diabetes who live in less wealthy countries and do not have access to more expensive treatments.
The review appears in BMC Biotechnology.

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