What is metformin for
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Metformin: Uses and Benefits
Introduction to Metformin
Metformin is a biguanide drug that has been used for over 60 years, primarily for the treatment of type 2 diabetes mellitus. It is known for its safety, low cost, and efficacy in lowering plasma glucose levels1 2 3. Over the years, research has uncovered various additional benefits of metformin, extending its use beyond diabetes management.
Metformin for Type 2 Diabetes
Glycemic Control and Weight Management
Metformin is widely recognized as the first-line treatment for type 2 diabetes due to its ability to improve glycemic control without causing weight gain. It works primarily by reducing hepatic glucose production and improving insulin sensitivity2 4 5. Studies have shown that metformin significantly benefits glycemic control, weight management, and lipid profiles compared to other diabetes medications2 4.
Cardiovascular Benefits
Metformin has been associated with cardiovascular protective effects, which are crucial given the high morbidity and mortality rates associated with cardiovascular disease in diabetic patients. These benefits include reductions in cardiovascular events and improvements in endothelial function, independent of its glucose-lowering effects4 9 10.
Metformin Beyond Diabetes
Cancer Prevention and Treatment
Emerging evidence suggests that metformin may have anti-tumorigenic properties. It is thought to activate AMP-activated protein kinase (AMPK), which inhibits the mammalian target of rapamycin (mTOR), a pathway involved in cancer cell growth. Observational studies have linked metformin use with a reduced risk of various cancers, including breast, colorectal, and endometrial cancers, although more conclusive data from randomized trials are awaited1 6.
Obesity and Metabolic Syndrome
Metformin has shown promise in treating obesity and metabolic syndrome by reducing visceral fat and suppressing inflammation in white adipose tissue. It also helps in managing weight gain associated with antipsychotic medications3 7.
Liver Diseases
Metformin is being studied for its potential benefits in nonalcoholic fatty liver disease (NAFLD). It appears to decrease hepatocyte triglyceride accumulation and may prevent liver tumorigenesis, although clinical evidence is still limited3.
Polycystic Ovary Syndrome (PCOS)
Metformin is also used to manage polycystic ovary syndrome (PCOS), a condition characterized by insulin resistance. It helps in improving insulin sensitivity and reducing hyperinsulinemia, which can alleviate some symptoms of PCOS3 7.
Mechanisms of Action
The precise mechanisms by which metformin exerts its effects are complex and not fully understood. It is known to reduce hepatic glucose production and improve peripheral glucose uptake. At the molecular level, metformin acts through both AMPK-dependent and AMPK-independent pathways, including inhibition of mitochondrial respiration and possibly mitochondrial glycerophosphate dehydrogenase5.
Conclusion
Metformin remains a cornerstone in the management of type 2 diabetes due to its efficacy, safety, and additional benefits beyond glucose control. Its potential applications in cancer prevention, obesity, liver diseases, and PCOS highlight its versatility as a therapeutic agent. Ongoing research continues to uncover new mechanisms and potential uses for this well-established drug.
Sources and full results
Most relevant research papers on this topic
Metformin and Its Benefits for Various Diseases
Metformin offers benefits for various diseases and aging, with potential underlying mechanisms still unclear.
Highly CitedWITHDRAWN: Metformin monotherapy for type 2 diabetes mellitus.
Metformin monotherapy effectively improves diabetes-related outcomes and reduces all-cause mortality in obese patients, but its effectiveness in overweight patients remains unclear.
Meta-Analysis
Very Rigorous JournalHighly CitedMetformin: An Old Drug with New Applications
Metformin may treat nonalcoholic fatty liver disease, cancer, obesity, and metabolic syndrome, but more clinical evidence is needed to confirm its benefits and prevent liver tumorigenesis.
Highly CitedMetformin: clinical use in type 2 diabetes
Metformin is a popular oral glucose-lowering medication for type 2 diabetes, with benefits including improved lipids, reduced cardiovascular events, and a lenient regulatory approach for patients with mild renal dysfunction.
Rigorous JournalHighly CitedThe mechanisms of action of metformin
Metformin improves glucose metabolism and diabetes-related complications through multiple mechanisms, including reducing hepatic glucose production and a key role for the gut.
Rigorous JournalHighly CitedMetformin in cancer.
Metformin may have potential anti-tumorgenic effects, but its effectiveness in treating cancer remains inconclusive.
Highly CitedMetformin: a review of its potential indications
Metformin may have potential roles beyond glucose lowering in type 2 diabetes, including antitumor effects, antiaging, cardiovascular protection, neuroprotective effects, and polycystic ovary syndrome treatment.
Literature ReviewRigorous JournalHighly CitedMetformin: historical overview
Metformin has become the most prescribed glucose-lowering medicine worldwide for managing type 2 diabetes, with its history linked to Galega officinalis, a traditional herbal medicine in Europe.
Rigorous JournalHighly CitedMetformin therapy and clinical uses
Metformin is a first-line antidiabetic therapy for type 2 diabetes, with potential benefits in other insulin-resistant states and tumor suppression.
Highly CitedMetformin is not just an antihyperglycaemic drug but also has protective effects on the vascular endothelium
Metformin, a first-choice treatment for type 2 diabetes, also has vascular protective effects, improving endothelial function and reducing cardiovascular disease risk.
Literature ReviewRigorous JournalHighly Cited