Can intensive insulin therapy improve blood circulation and reduce foot ulcers in type 1 diabetics?

This study investigated whether blood circulation in the skin is improved and whether the frequency of foot ulcers is decreased in patients taking intensive insulin therapy. 

Foot ulcers are a common complication of type 1 diabetes (T1D). Chronic high blood glucose (sugar) levels can damage the small blood vessels supplying the foot. This can result in reduced blood supply and death of the tissue in the foot. Damage to the nerves in the foot can also affect blood supply. A lack of blood supply in the foot can lead to leg amputation. Intensive insulin therapy can reduce high blood glucose levels and therefore reduce the damage to blood vessels. It is believed that intensive insulin therapy can improve the microcirculation (flow of blood in the small blood vessels) in the skin and reduce the frequency of foot ulcers.

This study compared the efficiency of circulation and the frequency of foot ulcers in diabetics taking intensive insulin therapy to standard insulin therapy. This study involved 72 patients divided in to 2 groups. 35 participants were randomly placed in the intensive insulin therapy group and 37 were randomly placed in the standard insulin therapy group. HbA1c (a measurement of average blood glucose levels over the past 3 months) and cholesterol levels were measured in each individual. Participants were followed for an average of 28 years.

9% of participants taking intensive insulin therapy developed a foot ulcer, in comparison to 29% of participants taking standard insulin therapy. HbA1c was lower in participants in the intensive insulin therapy group (average HbA1c of 7.4%) compared to those in the standard insulin therapy group (average HbA1c of 8.4%). Blood flow was greater in participants taking intensive insulin therapy compared to those taking standard insulin therapy. 

This study concluded that intensive insulin therapy is associated with improved blood glucose levels, improved circulation and a lower frequency of foot ulcers in T1D patients.

The sample size of 72 participants was quite small. The method of measuring blood flow could have been influenced by other factors such as age which were not accounted for. 

Consult your physician regarding the adjustments which can be made to your insulin regimen to reduce diabetic complications.