Hydrogel-Based drug delivery systems for diabetes bone defects

• Smart hydrogels in the microenvironment of diabetic bone defects are emphasized. • Design strategies of hydrogel drug delivery systems for drug release are discussed. • Applications of biomaterials and drugs in hydrogel drug-loading systems are described. • Bone repair mechanisms of innovative hydrogel drug-loading systems are elucidated. Hydrogel-based drug delivery systems have emerged at the forefront of therapeutic strategies for addressing diabetes-associated complications, including bone defects, wound healing impairments, periodontitis, and arthritis. This review describes cutting-edge developments in hydrogel technologies for the treatment of diabetic bone defects, highlighting the capacity of hydrogels to closely mimic the microenvironment of the extracellular matrix for optimal drug delivery and tissue regeneration. These systems distinguish themselves through their superior biocompatibility, responsiveness to physiological stimuli, and ability to undergo structural modifications to cater to specific therapeutic needs. Notably, the incorporation of nanotechnology and DNA engineering within hydrogel frameworks has significantly propelled their functionality forward, enabling precise and controlled release mechanisms. Through a series of exemplary innovations—ranging from smart responsive hydrogels enriched with anti-inflammatory factor to DNA hydrogels formulated with dual osteogenic and angiogenic capabilities—this review illuminates the profound impact of these hydrogels on modulating immune responses, curtailing inflammation, fostering angiogenesis, and bolstering osteogenic differentiation, which effectively facilitates the bone repair in diabetic conditions. The convergence of these attributes underscores the transformative potential of hydrogel drug-loading systems in refining diabetes-related treatment paradigms, heralding a new era of enhanced, personalized medical solutions.