Effect of glucose-lowering therapy on the course of the wound healing process in patients with type 2 diabetes mellitus and/or obesity

This review analyzes publications on the effect of glucose-lowering drugs on the wound healing process. Diabetes mellitus and obesity have a negative effect on wound repair processes, slowing down and disrupting their stages, which leads to the development of chronic non-healing wounds. Understanding of the use of glucose-lowering drugs is expanding significantly. In addition to the main glucose-lowering effect, it is of interest to study the pleiotropic effects of both metformin, which has been used in clinical practice for more than 60 years, and more modern drugs from the sodium-glucose cotransporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors, sulfonylureas, meglitinides, glucagon-like peptide-1 receptor agonists, and the dual glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide receptor agonist tirzepatide. The anti-inflammatory and reparative effects of these drugs are being investigated, the clinical application of which may open up new prospects in the treatment of wounds. Studies have shown that the use of these drug groups demonstrated a positive effect on regenerative processes in vitro and reduced the time and improved the quality of wound healing in vivo. The authors identify the following promising areas for further research: evaluating the efficacy of using incretin-based drugs and topical formulations of glucose-lowering drugs as wound-healing agents, including for acute wounds not associated with metabolic disorders, as well as the safety of their use in humans, including in individuals with a neutral metabolic status.