Dalal Alfawaz¹ , Rania Magadmi¹, Fatmah Alghamdi¹, Duaa Bakhshwin¹, Ahmed Bakhshwin², Ahmed Esmat^1,3

Abstract

Diabetes mellitus (DM) and its associated morbidities embody a significant challenge and considerable strain on healthcare sectors globally. Significantly, impaired wound healing is a common complication associated with poorly managed diabetes, often leading to adverse consequences. The diabetic wound results from a perpetual state of localized inflammation induced by the over-accumulation of proinflammatory cells along with their cytokines and proteases. Sodium-glucose cotransporter-2 (SGLT 2) inhibitors represent one of the classes of novel antidiabetic drugs that have shown promising effects in promoting wound healing, largely due to their anti-inflammatory properties. The findings in this review were synthesized using authoritative sources and advanced research tools. Searches on platforms such as Google Scholar, PubMed, Scopus, and JSTOR yielded high-quality peer-reviewed articles. Furthermore, the use of generic medication names referenced in this study, combined with terms such as "wound healing" and "diabetes," facilitated a precise and comprehensive analysis of their therapeutic implications. Reference materials were sourced from eminent journals like ScienceDirect and The Lancet, providing a robust empirical foundation, while esteemed repositories such as the World Health Organization (WHO) enriched the discourse with authoritative insights. This review focused on the potential impact of SGLT-2 inhibitors, namely, empagliflozin and dapagliflozin, on promoting wound healing. It will also discuss the mechanistic pathways by which this process is thought to occur. The current pool of evidence favors the notion that certain antidiabetic medications possess anti inflammatory properties that aid in preventing wounds from being in a perpetual inflammatory stage; this is thought to be accomplished by the downregulation of proinflammatory cytokines, upregulation of specific growth factors, reduction of metalloproteinases, promotion of angiogenesis, and enhancement of epithelialization. Nevertheless, this remains a fertile area for further research before these antidiabetic medications may be incorporated into clinical guidelines as therapeutic agents in the management of chronic wounds.