Wound healing potential of insulin sensitizers-thiazolidinedione pioglitazone and biguanide metformin

Author: 
Patil T. Patil T., Patil ST., PatilSnehal and PatilAnuprita

Diabetes mellitus is a noninfectious disease having high morbidity and mortality due to the complications arising as a result of uncontrolled hyperglycemia, excessive advanced glycation end products and vasculopathy affecting various vital organs. Frequently encountered complication of diabetes mellitus is a chronic wound, the treatment of which is still unsatisfactory. The choice of antidiabetic drugs can modify the course of wound healing favorably. Various studies have proved that Insulin sensitizers like thiazolidinediones and biguanides accelerate the wound healing. They are not hypoglycemic drugs hence they are quite safe. If they are selected after ruling out the contraindications and keeping a watch on their adverse drug reactions they prove to be a best choice. Thiazolidinedione drug pioglitazone promotes wound healing due to its anti-inflammatory, antioxidant mechanisms and by controlling the production of advanced glycation end products and the inhibition of expression of matrix metalloproteinase-9.Metformin, a biguanide drug activates AMPK, controls hyperglycemia, inhibits the generation of advanced glycation end products, promotes angiogenesis, possesses strong antiinflammatory and antioxidant properties and thereby accelerate the process of wound healing. These drugs need to be studied by various clinical trials to encourage their use regularly for wound healing. The local use of pioglitazone needs to be studied for wound healing as metformin has already been proved to heal the wounds after local application. Metformin forms a superior drug choice than pioglitazone as it has additional antimicrobial property and affects the hemostasis favorably to maintain the blood flow.

Page: 
3661-3666
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DOI: 
http://dx.doi.org/10.24327/23956429.ijcmpr20180535
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