Diabetes mellitus is associated with progressive vascular, inflammatory, infectious, and regenerative complications that remain difficult to manage because they involve interconnected mechanisms, including oxidative stress, chronic inflammation, apoptosis, endothelial dysfunction, impaired angiogenesis, and defective extracellular matrix remodeling. This review aimed to evaluate the mechanistic basis, therapeutic potential, and translational readiness of fucoidan-coated silver nanoparticles (AgNP-Fuc) for diabetic complications beyond their conventional antimicrobial activity. An integrative narrative review was conducted by synthesizing direct evidence on AgNP-Fuc together with relevant AgNP-only and fucoidan-only studies to distinguish established findings from mechanistic extrapolations.
Silver nanoparticles (AgNPs) are widely investigated for their antimicrobial and antibiofilm activity in infected diabetic wounds, whereas fucoidan, a sulfated polysaccharide derived from brown seaweed, contributes antioxidant, anti-inflammatory, antifibrotic, endothelial-protective, and pro-healing properties. Coating AgNPs with fucoidan may improve colloidal stability, moderate silver-ion release, reduce nonspecific cytotoxicity, and provide a biologically active interface that supports diabetic tissue repair. The available evidence indicates that topical AgNP-Fuc has the strongest translational rationale for
diabetic wound healing because it may simultaneously target infection control, redox balance, inflammatory regulation, angiogenesis, fibroblast activity, collagen organization, and re-epithelialization. In contrast, applications in diabetic nephropathy, retinopathy, neuropathy, and cardiovascular complications remain early-stage and are supported mainly by indirect or mechanistic evidence. Therefore, AgNP-Fuc should currently be considered a promising topical platform for diabetic wound management, while systemic or organ-specific applications require rigorous validation of pharmacokinetics, biodistribution, silver safety, formulation reproducibility, and therapeutic efficacy before clinical translation.