This review explores the potential of metformin, a widely used type 2 diabetes medication, in accelerating wound healing. Derived from guanidine compounds found in <i>Galega officinalis</i>, a plant with a long history in traditional medicine, metformin has been recognized for its minimal side effects. Beyond its primary role in diabetes treatment, metformin shows promising non-diabetic benefits, particularly in wound healing. Research indicates that metformin enhances wound healing through multiple mechanisms. It increases circulating endothelial progenitor cells, improves vascular function, and regulates thrombospondin-1 levels. Metformin also modulates the AMPK/mTOR/NLRP3 inflammasome signaling pathway, promoting M2 macrophage polarization, which is crucial for tissue repair. Additionally, it reduces pro-inflammatory cytokines, increases growth factors, and decreases matrix metalloproteinases. Studies have shown that topical application of metformin accelerates wound contraction, closure, and overall healing. Furthermore, it has been found to reduce fibrosis-related gene expression and improve collagen synthesis. With chronic wounds affecting millions globally and causing significant healthcare costs, there is a pressing need for improved wound healing agents. This review advocates for further research to establish clinical guidelines on using metformin to enhance wound healing. By harnessing metformin’s pleiotropic effects, healthcare providers may offer personalized treatments that not only manage diabetes but also promote wound healing.
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