How long has metformin been on the market
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The History and Market Presence of Metformin
Introduction to Metformin
Metformin, a biguanide, is a cornerstone in the treatment of type 2 diabetes mellitus. Its primary mechanism involves the suppression of endogenous glucose production, primarily by the liver, and it has been associated with several beneficial effects on cardiovascular risk factors 35.
Early Development and Rediscovery
The origins of metformin can be traced back to the traditional herbal medicine Galega officinalis, which was found to be rich in guanidine, a compound known to lower blood glucose levels as early as 1918. However, it wasn't until the 1940s that metformin was rediscovered during the search for antimalarial agents. Its glucose-lowering properties were pursued by the French physician Jean Sterne, who first reported its use in treating diabetes in 1957 .
Market Introduction and Adoption
Metformin's journey to widespread acceptance was not straightforward. Initially, it received limited attention due to the higher potency of other biguanides like phenformin and buformin, which were later discontinued due to their high risk of lactic acidosis. Despite these challenges, metformin's ability to manage hyperglycemia without causing weight gain or hypoglycemia gradually gained recognition, particularly in Europe. It was introduced into the USA in 1995 after intensive scrutiny .
Clinical Use and Popularity
Metformin has been in clinical use for over 60 years, marking its first clinical application in 1957. It has become the most widely prescribed antihyperglycemic agent, recommended as the first-line oral glucose-lowering agent in most clinical guidelines for managing type 2 diabetes 15. In the UK, it was prescribed to 83.6% of individuals with type 2 diabetes in 2013, and in the USA, it was consistently among the top ten most prescribed drugs from 2008 to 2012 .
Expanding Applications
Beyond its primary use in diabetes management, metformin has shown potential in treating various conditions such as cancer, obesity, nonalcoholic fatty liver disease (NAFLD), polycystic ovary syndrome (PCOS), and metabolic syndrome. Its role in reducing cardiovascular risks and improving endothelial function has also been well-documented 567.
Conclusion
Metformin's 60-year history in clinical use underscores its efficacy and safety in managing type 2 diabetes. Despite the advent of new drugs, metformin remains a first-choice treatment due to its comprehensive benefits and expanding therapeutic applications. Its journey from a traditional herbal remedy to a globally recognized medication highlights its enduring significance in medical practice.
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