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Peer-reviewedCC BY 4.0Frontiers in Pharmacology

Progesterone and diabetic wound repair: an evidence-gap review of indirect preclinical findings

Abstract

The case for natural progesterone in diabetic wound repair rests on indirect preclinical findings, not demonstrated wound-healing efficacy. This evidence-gap review separates natural progesterone, its neuroactive metabolites and synthetic progestins, and distinguishes ligand interventions from studies of similarly named targets. Structured searches on 29 August 2026 and a targeted check on 30 September 2026 identified no natural-progesterone intervention measuring healing efficacy in a diabetic cutaneous wound. Diabetic-neuropathy experiments report selected neural improvements, but nerve conduction or intraepidermal fibre density does not establish functional re-epithelialisation, glycaemia-independent benefit or recovery of protective sensation at a wound. Findings in non-diabetic skin and other tissues are heterogeneous. Murine dorsal wounds also differ from human diabetic foot ulcers in contraction, loading, chronicity and vascular disease. A proposed neural mechanism must therefore be tested against epithelial and barrier outcomes, adequate perfusion and matched glycaemic exposure. Opposing metabolic and endothelial findings, together with compound- and route-specific safety concerns, preclude a general prediction of benefit. The review provides an auditable evidence map and falsifiable experimental priorities; it does not support clinical progesterone supplementation for diabetes-related foot ulcers.

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BibTeX
@article{chen2026progesterone,
  title = {{Progesterone and diabetic wound repair: an evidence-gap review of indirect preclinical findings}},
  author = {Jianmin Chen and Pu Gao and Xiao Zhang and Cheng Long},
  journal = {Frontiers in Pharmacology},
  year = {2026},
  month = nov,
  doi = {10.3389/fphar.2026.2016207},
  url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.2016207},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Progesterone and diabetic wound repair: an evidence-gap review of indirect preclinical findings
AU  - Jianmin Chen
AU  - Pu Gao
AU  - Xiao Zhang
AU  - Cheng Long
PY  - 2026
DA  - 2026/11/05
JO  - Frontiers in Pharmacology
DO  - 10.3389/fphar.2026.2016207
UR  - https://www.frontiersin.org/articles/10.3389/fphar.2026.2016207
AB  - The case for natural progesterone in diabetic wound repair rests on indirect preclinical findings, not demonstrated wound-healing efficacy. This evidence-gap review separates natural progesterone, its neuroactive metabolites and synthetic progestins, and distinguishes ligand interventions from studies of similarly named targets. Structured searches on 29 August 2026 and a targeted check on 30 September 2026 identified no natural-progesterone intervention measuring healing efficacy in a diabetic cutaneous wound. Diabetic-neuropathy experiments report selected neural improvements, but nerve conduction or intraepidermal fibre density does not establish functional re-epithelialisation, glycaemia-independent benefit or recovery of protective sensation at a wound. Findings in non-diabetic skin and other tissues are heterogeneous. Murine dorsal wounds also differ from human diabetic foot ulcers in contraction, loading, chronicity and vascular disease. A proposed neural mechanism must therefore be tested against epithelial and barrier outcomes, adequate perfusion and matched glycaemic exposure. Opposing metabolic and endothelial findings, together with compound- and route-specific safety concerns, preclude a general prediction of benefit. The review provides an auditable evidence map and falsifiable experimental priorities; it does not support clinical progesterone supplementation for diabetes-related foot ulcers.
SN  - 1663-9812
ER  -