According to the International Diabetes Federation,
in Taiwan, about 13 out of 100 been diagnosed with diabetes (aged 20-79) in 2021,
and the total medical expenditure for diabetes was NT$ 29.7 billion. [1]

Besides Taiwan, diabetes has been a critical worldwide issue.
The number of people with diabetes has sharply increased over the past two decades.

By 2021, 537 million people will suffer from diabetes and it even caused 6.7 million deaths. Moreover, the health expenditure for diabetes has been 966 billion dollars- 9% of total spending on adults. [2]

An excessive blood sugar concentration
in patients suffering from diabetes inhibits the healing of skin wounds.
When it becomes severe, ordinary wounds can lead to amputations.

As the statistics in WHO indicated, people with diabetes have a 25% chance of foot ulcers in their lifetime[3] .

Additionally, Statistics from Taiwan Health Insurance Database showed that [4],

In Taiwan, about


diabetics undergo large and small amputations every year.

Once a diabetic foot ulcer occurs, the average life of the patient is only



the average life of the amputee is even only



Undoubtedly, diabetes has been a serious problem

Not only in Taiwan but even in the world.

Therefore, NCHU_Taichung aimed to develop a novel therapeutic, modified wound dressing for diabetes patients with an intrinsic compound- pyrroloquinoline quinone (PQQ), which is known to be able to boost cell growth.

To increase the yield of PQQ, a well-known probiotic was used- Bacillus subtilis natto. It acted as our host and was transformed with a refined PQQ plasmid shown in 2021 NCHU_Taichung.

Within the plasmid, we designed a xylose-dependent promoter implemented to regulate the biosynthesis rate. By wound healing assay, we used glucose-induced keratinocytes to examine the effect of PQQ. The results of the wound healing assay in HaCaT cells indicated that, when supplemented with PQQ, the cell migration would accelerate within 24 hours, compared with the untreated group.

This outcome provided concrete evidence to increase diabetes patients’ injury recovery and had a great potential to become a commercial product at a low cost.

  1. Taiwan Diabetes Report 2000-2045. (n.d.). International Diabetes Federation.
  2. IDF Diabetes Atlas | Tenth Edition. (n.d.). International Diabetes Federation.
  3. Yazdanpanah, L., Shahbazian, H., Nazari, I., Arti, H. R., Ahmadi, F., Mohammadianinejad, S. E., Cheraghian, B., & Hesam, S. (2018). Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)-Two-Year Follow-Up Study. International journal of endocrinology, 2018, 7631659.
  4. Jiang, Y. D., Chang, C. H., Tai, T. Y., Chen, J. F., & Chuang, L. M. (2012). Incidence and prevalence rates of diabetes mellitus in Taiwan: analysis of the 2000-2009 Nationwide Health Insurance database. Journal of the Formosan Medical Association = Taiwan yi zhi, 111(11), 599–604.