Diabetic Foot Treatment in Cuba
Cuba's Heberprot-P (recombinant human Epidermal Growth Factor) therapy — a pioneering treatment for diabetic foot ulcers — may be considered as part of an international wound care program.
Overview
Diabetic foot is a serious complication of diabetes, characterized by ulcers (open wounds), infections, and tissue damage in the feet. It is caused by a combination of neuropathy (nerve damage that reduces feeling), peripheral arterial disease (poor blood flow to the legs and feet), and impaired wound healing. Diabetic foot ulcers are a leading cause of non-injury-related lower limb amputation worldwide. Cuba's Center for Genetic Engineering and Biotechnology (CIGB) has developed Heberprot-P, a recombinant (lab-made) human Epidermal Growth Factor (EGF) — a protein that helps skin and tissue cells grow and heal. It is injected directly into the wound to stimulate tissue healing. Heberprot-P has been used in Cuba and many other countries for the treatment of advanced diabetic foot ulcers.
Symptoms
- Persistent foot ulcers or wounds that do not heal
- Loss of sensation or tingling in the feet (neuropathy)
- Changes in skin color or temperature of the feet
- Swelling of the foot or ankle
- Pain or discomfort in the legs while walking (claudication)
- Signs of infection (redness, warmth, pus, foul odor)
- Thickened, yellow toenails
- Dry, cracked skin on the feet
Risk Factors
- Long-standing diabetes (especially type 2)
- Poor glycemic control
- Peripheral neuropathy
- Peripheral arterial disease
- Foot deformities (hammer toes, Charcot foot)
- Previous foot ulceration or amputation
- Smoking
- Poor foot care and hygiene
- Inappropriate footwear
- Visual impairment (difficulty inspecting feet)
Diagnosis
Diagnosis involves comprehensive foot examination, assessment of ulcer characteristics (size, depth, infection status), neurological testing (monofilament, tuning fork), vascular assessment (Doppler ultrasound, ankle-brachial index), imaging (X-ray, MRI) to check for bone infection (osteomyelitis), and laboratory tests to assess infection and glycemic control. Wagner or University of Texas classification systems are used to grade ulcer severity. Cuban wound care centers utilize advanced diagnostic imaging and vascular assessment.
Disease Stages
Diabetic foot ulcers are classified using the Wagner system. Grade 0: Pre-ulcerative or post-ulcerative lesion with intact skin. Grade 1: Superficial ulcer. Grade 2: Deep ulcer extending to tendon, bone, or joint capsule. Grade 3: Deep ulcer with abscess, osteomyelitis, or joint sepsis. Grade 4: Localized gangrene (toes or forefoot). Grade 5: Extensive gangrene of the entire foot. Heberprot-P is typically considered for ulcers that have not responded to standard wound care (Grade 1-3).
Standard Treatment Options
woundCare
Standard wound care includes debridement of necrotic tissue, offloading (relieving pressure on the ulcer), appropriate dressings, infection management with antibiotics, and regular wound assessment. These measures are the foundation of diabetic foot ulcer treatment.
biotechnology
Heberprot-P (recombinant human Epidermal Growth Factor) is a Cuban-developed biotechnology product that is injected directly into the wound bed to stimulate tissue healing. It is indicated for diabetic foot ulcers that have not responded to standard wound care. Heberprot-P has been used in Cuba and many other countries and has shown promising results in promoting wound closure.
vascular
Vascular intervention may be necessary for patients with peripheral arterial disease. This may include angioplasty, stenting, or bypass surgery to improve blood flow to the foot. Vascular assessment is an important component of the evaluation process.
surgical
Surgical intervention may be necessary for debridement of infected tissue, drainage of abscesses, correction of foot deformities, or in severe cases, amputation. The goal of treatment is to prevent amputation whenever possible.
supportive
Supportive care includes glycemic control, nutritional support, pain management, treatment of comorbidities, patient education on foot care, and provision of appropriate footwear. Ongoing foot care education is essential to prevent recurrence.
rehabilitation
Rehabilitation may be needed after treatment, including physical therapy to maintain mobility, use of orthotic devices, and gradual return to normal activity. Offloading devices (crutches, special boots, wheelchairs) may be used during the healing process.
Potential Treatment Approaches in Cuba
Cuba's approach to diabetic foot centers on Heberprot-P (recombinant human Epidermal Growth Factor), developed by the Center for Genetic Engineering and Biotechnology (CIGB) in Havana. Heberprot-P is injected directly into the wound bed, where it stimulates cell proliferation and tissue healing. Clinical studies have shown that Heberprot-P may promote wound closure in diabetic foot ulcers that have not responded to standard wound care, potentially reducing the need for amputation. Heberprot-P is registered in Cuba and many other countries. For international patients, the process begins with a thorough review of medical records to determine if Heberprot-P therapy may be appropriate for their specific case.
Explore Cuba's Treatment for This Condition
Cuba offers specialized treatment programs for this condition. Learn more about the therapy, eligibility, and how to request a medical evaluation.
Who May Be Eligible
Eligibility for Heberprot-P therapy is determined through medical review of the patient's diabetes status, ulcer characteristics (size, depth, duration, infection status), vascular status, glycemic control, and overall health. Heberprot-P is typically indicated for diabetic foot ulcers (Wagner Grade 1-3) that have not responded to standard wound care. Each case is evaluated individually by the Cuban wound care team. Patients must provide complete medical records including diabetes history, ulcer assessment, and imaging for review.
Required Medical Documents
- Diabetes diagnosis and treatment history (type, duration, medications, HbA1c)
- Foot ulcer assessment (location, size, depth, duration, Wagner grade)
- Vascular assessment (Doppler ultrasound, ankle-brachial index)
- Neurological assessment (monofilament testing)
- X-ray or MRI of the foot to check for osteomyelitis
- Current medication list including diabetes medications
- Recent general blood panel (CBC, HbA1c, kidney and liver function)
- Wound care history including previous treatments
How to Request a Medical Evaluation
Submit your medical records for review by our oncology team. If treatment may be appropriate for your case, a personalized plan will be developed. You only travel to Cuba after the medical team confirms eligibility.
Frequently Asked Questions
What is Heberprot-P and how does it work?
Heberprot-P is a recombinant human Epidermal Growth Factor (EGF) product developed by Cuba's Center for Genetic Engineering and Biotechnology. It is injected directly into the wound bed, where it stimulates cell proliferation and tissue healing. Heberprot-P is indicated for diabetic foot ulcers that have not responded to standard wound care.
Can international patients receive Heberprot-P treatment in Cuba?
Yes. International patients may be evaluated for Heberprot-P therapy through SMC Salud. The process begins with a medical review of your records. If the wound care team determines the therapy may be appropriate, a personalized treatment plan is developed.
Can Heberprot-P cure diabetic foot ulcers?
No treatment can guarantee a cure for diabetic foot ulcers. Heberprot-P has shown promising results in promoting wound closure in ulcers that have not responded to standard wound care, potentially reducing the need for amputation. However, outcomes vary by individual and depend on the ulcer characteristics, vascular status, glycemic control, and the patient's overall health.
How long does diabetic foot treatment in Cuba take?
The treatment duration varies by individual case. Heberprot-P is typically administered through a series of intralesional injections over several weeks. Your medical team will provide a personalized timeline after reviewing your records.
Can my medical records be reviewed before I travel?
Yes. Medical record review is a required first step. You submit your documents remotely, and the wound care team reviews them to determine whether treatment may be appropriate. You only travel to Cuba if the team confirms that evaluation or treatment may be offered.
References
- Fernández-Montequín JI, et al. Intralesional administration of epidermal growth factor (Heberprot-P) in advanced diabetic foot ulceration. International Wound Journal.
- World Health Organization — Diabetes Fact Sheet.
- International Working Group on the Diabetic Foot — Consensus Guidelines.
Medical Disclaimer
The medical information provided on this page is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Eligibility for any treatment depends on the patient's clinical condition and is determined by the treating medical team.
This content has been medically reviewed by qualified physicians and follows SMC Salud's editorial policy for health information. Medical content is for informational purposes and does not replace professional medical advice.