Reducing oxidative stress and enhancing antioxidant defenses for faster healing in diabetic wounds: The role of topical metformin

Abstract

Objectives: Hyperglycemia, one of the most important metabolic indicators of diabetes, causes increased oxidative stress and inflammation both systemically and locally at the tissue level, particularly in chronic wound sites where healing is impaired. Increased oxidative stress products are controlled by the body's antioxidant capacity. Oxidative damage develops as a result of excessive production or improper quenching of reactive oxygen species (ROS) and is an important cause of non-healing chronic wounds. We aimed to accelerate wound healing by increasing the antioxidant capacity of oxidative damage caused by diabetes by applying metformin, which is routinely used orally, topically on wounds. Methods: For this purpose, we applied metformin on diabetic and non-diabetic wounds for 14 days and measured oxidative stress markers malondialdehyde (MDA), total antioxidant status (TAS), total oxidant status (TOS) levels, and antioxidant levels of glutathione (GSH) and catalase (CAT) in wound samples obtained by biopsy using ELISA technique. Results: The markers of oxidative stress increased in untreated diabetic rats because of hyperglycemia, the most important clinical marker of diabetes, compared to non-diabetic rats. In contrast, our results showed that metformin administration decreased oxidative stress markers and increased antioxidant levels compared to controls. Conclusion: As a result, it has been revealed that topically applied metformin can minimize oxidative damage caused by hyperglycemia by increasing antioxidant capacity, especially in diabetic wounds, and thus wounds heal faster by controlling oxidative stress in wound healing. Keywords: Antioxidant, diabetes mellitus, metformin, oxidative stress, wound healing