Metformin names
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Metformin: Names and Historical Overview
Introduction to Metformin (Dimethylbiguanide)
Metformin, also known by its chemical name dimethylbiguanide, is a widely used oral medication primarily prescribed for managing type 2 diabetes mellitus. It is recognized for its efficacy in lowering blood glucose levels and its favorable safety profile .
Historical Background and Development
Origins from Galega Officinalis
The history of metformin dates back to the use of Galega officinalis, commonly known as goat’s rue, a traditional herbal medicine in Europe. This plant was found to be rich in guanidine, a compound that was shown to lower blood glucose levels as early as 1918.
Rediscovery and Clinical Use
Metformin was rediscovered in the 1940s during the search for antimalarial agents. Its glucose-lowering properties were noted during clinical tests for influenza treatment. French physician Jean Sterne first reported its use for diabetes treatment in 1957. Despite its initial limited attention due to the higher potency of other biguanides like phenformin and buformin, metformin eventually gained prominence due to its lower risk of lactic acidosis.
Metformin in Modern Medicine
First-Line Therapy for Type 2 Diabetes
Metformin is now the preferred first-line oral blood glucose-lowering agent for type 2 diabetes. It is recommended by various guidelines, including those from the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA), due to its efficacy, low cost, weight neutrality, and good safety profile .
Broader Therapeutic Applications
Beyond diabetes, metformin has shown potential benefits in treating a variety of conditions, including cancer, obesity, nonalcoholic fatty liver disease (NAFLD), polycystic ovary syndrome (PCOS), and metabolic syndrome. It has also been studied for its effects on cardiovascular health and its ability to alleviate weight gain associated with antipsychotic medications .
Mechanisms of Action
Glucose Control and Insulin Sensitivity
Metformin primarily works by inhibiting hepatic gluconeogenesis and improving peripheral glucose utilization. It activates AMP-activated protein kinase (AMPK), which plays a crucial role in cellular energy homeostasis, and may also influence other pathways related to insulin and inflammatory responses .
Potential Anti-Cancer Effects
Emerging evidence suggests that metformin may have anti-tumorigenic properties, potentially reducing the risk of various cancers. This effect is thought to be mediated through AMPK activation and other pathways that reduce insulin, insulin-like growth factor-1, and inflammatory markers .
Conclusion
Metformin, or dimethylbiguanide, has a rich history and a well-established role in the management of type 2 diabetes. Its benefits extend beyond glucose control, offering potential therapeutic effects for a range of other conditions. As research continues, metformin's applications may broaden, further solidifying its status as a cornerstone in modern medicine.
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