Emerging concepts in metformin therapy: Hyperglycaemia and beyond

Metformin has been extensively used in the management of type 2 diabetes mellitus (T2DM). A number of properties combined, including cost effectiveness, safety, weight neutrality, low risk of Hypoglycemia and cardiovascular protection moved metformin to the forefront of diabetes management and is now accepted as the standard first line therapy. Although other classes of glucose lowering medications were introduced to clinical practice in the recent times, none of such therapies has as yet demonstrated superiority to metformin to justify being considered as a first line therapeutic option. The use of metformin has extended in the last 2 decades to include diabetes prevention, gestational diabetes mellitus (GDM) and polycystic ovary syndrome (PCOS). There is accumulating evidence from observational studies to suggest a possible role for metformin in cancer prevention and in the management of non-alcoholic fatty liver disease. We reviewed the role of metformin in the prevention and treatment of T2DM and allied metabolic disorders and examined the non- glycaemic effects of metformin. In addition, we reviewed safety aspects pertinent to the usage of metformin in special clinical settings.

Key-words:

Metformin - type 2 diabetes - Insulin resistance - Cardiovascular protection - Cancer - Gastrointestinal intoler- ability - Lactic acidosis - Gestational diabeted mellitus.

Publication History

Received: 26 July 2013

Accepted: 27 July 2012

Article published online:
07 July 2022