Metformin

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Metformin

Metformin, sold under the brand name Glucophage, among others, is the main first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight. It is also used in the treatment of polycystic ovary syndrome, and is sometimes used as an off-label adjunct to lessen the risk of metabolic syndrome in people who take antipsychotic medication. It has been shown to inhibit inflammation, and is not associated with weight gain. Metformin is taken by mouth. Metformin is generally well tolerated. Common adverse effects include diarrhea, nausea, and abdominal pain. It has a small risk of causing low blood sugar. High blood lactic acid level (acidosis) is a concern if the medication is used in overly large doses or prescribed to people with severe kidney problems. Metformin is a biguanide anti-hyperglycemic agent. It works by decreasing glucose production in the liver, increasing the insulin sensitivity of body tissues, and increasing GDF15 secretion, which reduces appetite and caloric intake. Metformin was first described in the scientific literature in 1922 by Emil Werner and James Bell. French physician Jean Sterne began the study in humans in the 1950s. It was introduced as a medication in France in 1957. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. In 2023, it was the second most commonly prescribed medication in the United States, with more than 85 million prescriptions. In Australia, it was one of the top 10 most prescribed medications between 2017 and 2023.

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• Metformin and Its Benefits for Various Diseases - PMC

  Moreover, metformin improves insulin sensitivity and decreases fasting insulin levels in cognitive impairment patients with abnormal glucose metabolism (31). Metformin is a rational treatment choice for pregnant women with T2D, gestational diabetes (GDM), and polycystic ovarian syndrome (PCOS). Metformin was shown to have a stronger reducing effect on the body weight of PCOS patients than rosiglitazone. On the basis of in vitro and in vivo studies, including animal studies and clinical trials, the use of metformin in pregnancy is becoming increasing common globally (32). Nevertheless, the safety is controversial. Studies showed that children exposed to metformin may have a higher prevalence of obesity, BMI, abdominal fat volume, or blood pressure (33, 34). Other research suggested that [...] Metformin is a widely used biguanide drug due to its safety and low cost. It has been used for over 60 years to treat type 2 diabetes at the early stages because of its outstanding ability to decrease plasma glucose levels. Over time, different uses of metformin were discovered, and the benefits of metformin for various diseases and even aging were verified. These diseases include cancers (e.g., breast cancer, endometrial cancer, bone cancer, colorectal cancer, and melanoma), obesity, liver diseases, cardiovascular disease, and renal diseases. Metformin exerts different effects through different signaling pathways. However, the underlying mechanisms of these different benefits remain to be elucidated. The aim of this review is to provide a brief summary of the benefits of metformin and to [...] Metformin is a widely used clinical drug with numerous benefits (Table 1), which through different signaling pathways (Figure 1). The most remarkable feature of metformin is anti-hyperglycemia. Cellular and animal studies have found that metformin inhibited the expression of gluconeogenic genes in AMPK dependent pathway or independent pathway, to suppress hepatic glucose production. Besides, metformin decreases glucose levels through impairing lactate utilization for gluconeogenesis, enhancing glucose transport and uptake, or changing gut microbiota. Accumulated clinical trials have evaluated that metformin had benefits on different cancers. Metformin prevents growth, survival, and metastasis of tumor cells and also changes the tumor microenvironment to suppress cancer development. The

• Metformin - StatPearls - NCBI Bookshelf - NIH

  Metformin, an antidiabetic agent, was approved by the U.S. Food and Drug Administration (FDA) in 1994 for treating type 2 diabetes. This medication comes in both immediate- and extended-release formulations and is often combined with other antidiabetic agents. The off-label indications of metformin include managing gestational diabetes, addressing weight gain issues caused by antipsychotic medication, preventing type 2 diabetes, and treating and preventing polycystic ovary syndrome (PCOS). Metformin is currently the only antidiabetic medication for prediabetes recommended by the American Diabetes Association (ADA). Furthermore, regarding potential indications, researchers are studying metformin for its possible antiaging, anticancer, and neuroprotective effects. This activity offers a [...] ## Mechanism of Action Metformin, classified as a biguanide drug, effectively lowers blood glucose levels by decreasing glucose production in the liver, diminishing intestinal absorption, and enhancing insulin sensitivity. As a result, metformin effectively lowers both basal and postprandial blood glucose levels. Metformin plays a crucial role in PCOS by reducing insulin levels, which leads to decreased luteinizing hormone and androgen levels. This normalization of hormone levels helps regulate the menstrual cycle in women. Clinicians must advise premenopausal women about the increased potential for pregnancy while taking metformin.(#article-25065.r3) [...] When individuals are diagnosed with type 2 diabetes, doctors typically suggest lifestyle modifications such as improving their diet and increasing their physical activity. Metformin is commonly prescribed as a monotherapy or in combination with other medications when lifestyle interventions, such as changes in diet and exercise, prove ineffective in lowering hyperglycemia. As per the American Diabetes Association (ADA), metformin stands as the preferred first-line agent for treating type 2 diabetes in both adult and pediatric patients 10 or older. According to the Standards of Medical Care in Diabetes 2018, if a patient's hemoglobin A1C (HbA1c) level is less than 9% at diagnosis, metformin monotherapy is the recommended approach. However, if the HbA1c level is greater than 9%, metformin

• Metformin: MedlinePlus Drug Information

  ## Why is this medication prescribed? Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood. Metformin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). [...] Your doctor may start you on a low dose of metformin and gradually increase your dose not more often than once every 1–2 weeks. You will need to monitor your blood sugar carefully so your doctor will be able to tell how well metformin is working. Metformin controls diabetes but does not cure it. Continue to take metformin even if you feel well. Do not stop taking metformin without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. ## Other uses for this medicine This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. ## What special precautions should I follow? ### Before taking metformin, [...] Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

• About metformin - NHS

  # About metformin Metformin is a medicine used to treat type 2 diabetes and gestational diabetes. It's also used to help prevent type 2 diabetes if you're at high risk of developing it. Type 2 diabetes is a condition where the body does not make enough insulin, or the insulin that it makes does not work properly. This can cause high blood sugar levels (hyperglycaemia). Metformin lowers your blood sugar levels by improving the way your body handles insulin. It's usually prescribed for diabetes when diet and exercise alone have not been enough to control your blood sugar levels. [...] Metformin is also used to improve fertility if you have polycystic ovary syndrome (PCOS), a condition that affects how the ovaries work. It may also be used to manage other symptoms of PCOS, but it is not officially approved to be used in this way. Metformin treats PCOS by lowering insulin and blood sugar levels. This can also improve ovulation and encourage regular periods, even if you do not have diabetes. Metformin is available on prescription as tablets, as a liquid that you swallow and as sachets of powder that you dissolve in a drink. ## Key facts

• Metformin - Wikipedia

  Metformin exerts an anorexiant effect in most people, decreasing caloric intake. Metformin decreases gluconeogenesis (glucose production) in the liver. Metformin inhibits basal secretion from the pituitary gland of growth hormone, adrenocorticotropic hormone, follicle stimulating hormone, and expression of proopiomelanocortin, which in part accounts for its insulin-sensitizing effect with multiple actions on tissues including the liver, skeletal muscle, endothelium, adipose tissue, and the ovaries. The average person with type 2 diabetes has three times the normal rate of gluconeogenesis; metformin treatment reduces this by over one-third. [...] Metformin has acid dissociation constant values (pKa) of 2.8 and 11.5, so it exists very largely as the hydrophilic cationic species at physiological pH values. The metformin pKa values make it a stronger base than most other basic medications with less than 0.01% nonionized in blood. Furthermore, the lipid solubility of the nonionized species is slight as shown by its low logP value (log(10) of the distribution coefficient of the nonionized form between octanol and water) of −1.43. These chemical parameters indicate low lipophilicity and, consequently, rapid passive diffusion of metformin through cell membranes is unlikely. As a result of its low lipid solubility, it requires the transporter SLC22A1 for it to enter cells. The logP of metformin is less than that of phenformin (−0.84) [...] The United Kingdom's National Institute for Health and Clinical Excellence recommended in 2004 that women with PCOS and a body mass index above 25 be given metformin for anovulation and infertility when other therapies fail to produce results. UK and international clinical practice guidelines do not recommend metformin as a first-line treatment or do not recommend it at all, except for women with glucose intolerance. The guidelines suggest clomiphene as the first medication option and emphasize lifestyle modification independently from medical treatment. Metformin treatment decreases the risk of developing type 2 diabetes in women with PCOS who exhibited impaired glucose tolerance at baseline. In Poland, metformin is listed as an approved and reimbursed treatment for PCOS.