Metagenomic insights into therapeutic strategies for chronic diabetic wounds: a review

Diabetes mellitus is a global metabolic disease with an increasing prevalence, particularly in Southeast Asia. Diabetic wounds are characterized by prolonged inflammation, excessive extracellular matrix degradation, and impaired angiogenesis, often leading to chronic, non-healing ulcers. Diabetic foot ulcers are a major complication of diabetes, affecting up to 34% of individuals with the condition. These ulcers result from hyperglycemia, poor circulation, and neuropathy, which collectively impair wound healing and increase the risk of infection. Additionally, microbial colonization and biofilm formation further complicate diabetic wound management. Understanding the microbial composition of diabetic wounds is crucial for developing effective therapeutic strategies. This article reviews diabetic wound severity assessment and microbiology, explores metagenomic techniques for microbial analysis, and discusses management approaches including targeted antimicrobial therapy, microbiome modulation, and emerging technologies.

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