Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From the American College of Physicians

Qaseem, Amir; Barry, Michael J.; Humphrey, Linda L.; Forciea, Mary Ann

doi:10.7326/m16-1860

Cited by 170 publications

(161 citation statements)

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“…Many studies on the pharmacokinetics, pharmacodynamics, clinical efficacy and cellular mechanisms of metformin have informed a favourable benefit:risk ratio that, alongside costeffectiveness, has elevated this agent to the preferred first-line glucose-lowering pharmacological therapy for type 2 diabetes in major national and international treatment guidelines and algorithms (for examples, see [75][76][77][78]). Metformin has become the most prescribed glucose-lowering therapy worldwide and it is now included in the World Health Organization's (WHO's) essential medicines list [79].…”

Section: First-line Pharmacological Choicementioning

confidence: 99%

Metformin: historical overview

2017

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Metformin (dimethylbiguanide) has become the preferred first-line oral blood glucose-lowering agent to manage type 2 diabetes. Its history is linked to Galega officinalis (also known as goat's rue), a traditional herbal medicine in Europe, found to be rich in guanidine, which, in 1918, was shown to lower blood glucose. Guanidine derivatives, including metformin, were synthesised and some (not metformin) were used to treat diabetes in the 1920s and 1930s but were discontinued due to toxicity and the increased availability of insulin. Metformin was rediscovered in the search for antimalarial agents in the 1940s and, during clinical tests, proved useful to treat influenza when it sometimes lowered blood glucose. This property was pursued by the French physician Jean Sterne, who first reported the use of metformin to treat diabetes in 1957. However, metformin received limited attention as it was less potent than other glucose-lowering biguanides (phenformin and buformin), which were generally discontinued in the late 1970s due to high risk of lactic acidosis. Metformin's future was precarious, its reputation tarnished by association with other biguanides despite evident differences. The ability of metformin to counter insulin resistance and address adult-onset hyperglycaemia without weight gain or increased risk of hypoglycaemia gradually gathered credence in Europe, and after intensive scrutiny metformin was introduced into the USA in 1995. Long-term cardiovascular benefits of metformin were identified by the UK Prospective Diabetes Study (UKPDS) in 1998, providing a new rationale to adopt metformin as initial therapy to manage hyperglycaemia in type 2 diabetes. Sixty years after its introduction in diabetes treatment, metformin has become the most prescribed glucose-lowering medicine worldwide with the potential for further therapeutic applications.

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Section: First-line Pharmacological Choicementioning

confidence: 99%

Metformin: historical overview

2017

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“…The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), in their joint [46][47][48]. However, beyond comparisons with sulfonlylureas and insulin, there are no long-term data comparing metformin as first-line treatment with other glucose-lowering agents (e.g.…”

Section: Guidelinesmentioning

confidence: 99%

Metformin: clinical use in type 2 diabetes

2017

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“…Метформин, если нет противопоказаний, является эффективной стратегией лечения, поскольку она имеет лучшую эффективность, связана с меньшим коли-чеством побочных эффектов и дешевле, чем большинство других пероральных препаратов [35]. Обсуждение безо-пасности антигипергликемических препаратов в отноше-нии сердечной недостаточности продолжается с акцентом на безопасность метформина и глифлозинов [36].…”

Section: сахарный диабет Diabetes Mellitus 213unclassified

Multidimensional effects of metformin in patients with type 2 diabetes

Ruyatkina¹,

Ruyatkin²

2017

Diabetes mellitus

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Диагностика, контроль, лечение Diagnosis, control, treatment современных алгоритмах антигипергликемизи-рующей терапии при сахарном диабете 2 типа (СД2) метформин занимает лидирующие по-зиции [1]. Этому предшествовала своеобразная драма в конце XX в., когда стало ясно, что разные группы са-хароснижающих препаратов могут противоположно влиять на риск сердечно-сосудистых событий (ССС). Так, вследствие негативного влияния на него первая ге-нерация производных сульфонилмочевины (СМ) ушла из клинической практики, тогда как для препаратов второй генерации такие эффекты не были характерны, что убедительно продемонстрировано в UKPDS, так же, как и для глимепирида -производного СМ третьей гене-рации [2]. На основании данных о повышении сердечно-сосудистого риска из медицинской практики ушли бигуаниды [3]

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Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From the American College of Physicians

Cited by 170 publications

References 0 publications

Metformin: historical overview

Metformin: historical overview

Metformin: clinical use in type 2 diabetes

Multidimensional effects of metformin in patients with type 2 diabetes

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