For someone living with a diabetic foot ulcer, fewer days with an open wound would be a meaningful gain. A new trial from Shanghai invites us to ask whether liraglutide could help deliver that gain, and what evidence we still need before changing care.
Li and colleagues’ randomized, placebo-controlled study in Diabetology & Metabolic Syndrome enrolled 105 people, with a mean age of 73.7 years. Participants received liraglutide (53) or saline placebo (52). It was a single-center, participant-blinded trial.
Important caveats: formal offloading was not routinely used, and the published two-arm design differs from the initial three-arm registry snapshot. Those questions need to sit alongside the healing results.
What the investigators reported
| Outcome | Liraglutide | Placebo |
|---|---|---|
| Mean healing time | 63.4 ± 23.5 days | 83.8 ± 21.7 days |
| Ulcer-area reduction at 1 month | 44.7 ± 14.3% | 38.2 ± 15.4% |
| Complete healing at 3 months | 86.8% | 59.6% |
| Amputation at 6 months | 5.6% | 3.8% |
Values with ± are mean ± standard deviation, not confidence intervals. Reported P values were <.001 for healing time, .026 for area reduction and .002 for complete healing. The amputation difference was not statistically significant.
The report does not explain how nonhealing ulcers or amputations were handled in the healing-time analysis. That is an important question when interpreting the reported means.
The separation in healing outcomes is worth testing in a larger trial. It should not be converted into a promise that an individual patient will heal a particular number of days sooner, or into a claim of amputation prevention.
SASP: an interesting biological question
SASP stands for senescence-associated secretory phenotype, the signaling molecules associated with senescent cells. Several circulating SASP-related markers fell more with liraglutide; GDF15 did not show a significant between-group difference.
Blood-marker changes do not establish that a treatment clears senescent cells from a wound, or that those changes caused healing. The next mechanistic studies should connect systemic measurements to wound tissue and test the proposed pathway directly. Similar glucose measurements between groups cannot, by themselves, prove a glucose-independent benefit.
The surrounding care matters
Formal offloading was not routinely used, and no participant underwent revascularization during the study. The trial therefore does not establish liraglutide’s added value over a fully specified multidisciplinary limb-preservation pathway. The report describes participant blinding but does not clearly establish blinded outcome assessment.
The next trial should specify and consistently deliver pressure relief, vascular assessment, infection management and wound care, then measure the medication’s added value. Durable closure, recurrence, mobility, treatment burden and limb outcomes all belong in that assessment.
One protocol question deserves clarification
The WHO ICTRP record for ChiCTR2500104914, last refreshed June 30, 2025, lists a planned three-arm study with 17 participants per arm. The publication reports a two-arm study of 105. We could not access the primary registry’s amendment history, so any protocol changes need clarification.
Keep the signal in proportion
Our earlier coverage of the STARDUST trial explored liraglutide and lower-limb perfusion. The present study brings a different question into focus: healing of an existing ulcer. Findings from different populations and endpoints should not be treated as interchangeable.
This is a reason to pursue better trials of liraglutide, not to assume a wound-healing effect across the entire GLP-1 receptor agonist class. Medication decisions remain individualized; this study alone does not justify prescribing a GLP-1 drug specifically for ulcer healing.
Faster healing is a worthwhile goal. The next step is to establish whether this encouraging signal persists when the drug is tested alongside clearly defined, comprehensive foot care.
Read the study
Li M, Yan C, Li J, et al. Effect of GLP-1RA on circulating SASP levels and wound healing in patients with diabetic foot ulcers: a randomized, placebo-controlled clinical trial. Diabetology & Metabolic Syndrome. Published October 17, 2026. doi:10.1186/s13098-026-02330-w. Full accepted manuscript.
Evidence note: This commentary reviews the article-in-press version available on October 30, 2026. The publisher notes that further edits may precede the final version of record.
#DiabeticFoot #WoundHealing #Liraglutide #LimbPreservation
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