Metformin monotherapy for adults with type 2 diabetes mellitus

Gnesin, Filip; Thuesen, Anne Cathrine Baun; Kähler, Lise Katrine Aronsen; Gluud, Christian; Madsbad, Sten; Hemmingsen, Bianca

doi:10.1002/14651858.cd012906

Cited by 9 publications

(8 citation statements)

References 66 publications

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“…Recent meta-analyses of randomized controlled trials with metformin mostly concluded an absence of evidence or a neutral effect regarding beneficial effects of metformin on cardiovascular outcomes ( Table 2 ) [ 57 , 58 , 59 , 60 ]. However, the available evidence is weak because most studies were poorly conducted [ 60 ]. With regard to beneficial cardiovascular effects of metformin, we will discuss three trials that are often quoted.…”

Section: Cardiovascular Effectsmentioning

confidence: 99%

Metformin: A Narrative Review of Its Potential Benefits for Cardiovascular Disease, Cancer and Dementia

2022

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The biguanide metformin has been used as first-line therapy in type 2 diabetes mellitus (T2DM) treatment for several decades. In addition to its glucose-lowering properties and its prevention of weight gain, the landmark UK Prospective Diabetes Study (UKPDS) demonstrated cardioprotective properties in obese T2DM patients. Coupled with a favorable side effect profile and low cost, metformin has become the cornerstone in the treatment of T2DM worldwide. In addition, metformin is increasingly being investigated for its potential anticancer and neuroprotective properties both in T2DM patients and non-diabetic individuals. In the meantime, new drugs with powerful cardioprotective properties have been introduced and compete with metformin for its place in the treatment of T2DM. In this review we will discuss actual insights in the various working mechanisms of metformin and the evidence for its beneficial effects on (the prevention of) cardiovascular disease, cancer and dementia. In addition to observational evidence, emphasis is placed on randomized trials and recent meta-analyses to obtain an up-to-date overview of the use of metformin in clinical practice.

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Section: Cardiovascular Effectsmentioning

confidence: 99%

Metformin: A Narrative Review of Its Potential Benefits for Cardiovascular Disease, Cancer and Dementia

2022

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“…In a study of 167,254 (46% women) patients with T2DM who were already using MTF and started newer anti-diabetic medications, the incidence of cardiovascular events, after a median observation time of 4.5 years, in women was lower compared to that of men (14.7 versus 16.7 per 1000-person-year) [ 73 ]. Nevertheless, a systematic review of MTF’s overall actions has not been conclusive regarding micro- and macrovascular complications in patients with T2DM [ 74 ].…”

Section: Sex/gender Differences Using Mtfmentioning

confidence: 99%

Metformin: Sex/Gender Differences in Its Uses and Effects—Narrative Review

Ilias¹,

Rizzo

Zabulienė

2022

Medicina

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Metformin (MTF) occupies a major and fundamental position in the therapeutic management of type 2 diabetes mellitus (T2DM). Gender differences in some effects and actions of MTF have been reported. Women are usually prescribed lower MTF doses compared to men and report more gastrointestinal side effects. The incidence of cardiovascular events in women on MTF has been found to be lower to that of men on MTF. Despite some promising results with MTF regarding pregnancy rates in women with PCOS, the management of gestational diabetes, cancer prevention or adjunctive cancer treatment and COVID-19, most robust meta-analyses have yet to confirm such beneficial effects.

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“…34 Metformin does not cause hypoglycemia or AKI, and the risk of lactic acidosis is exceptionally low. 35 In contrast, withdrawal of metformin in the perioperative period may lead to hyperglycemia. In the absence of contraindications, it would seem reasonable to continue metformin during the perioperative period, including on the day of surgery, aligning with guideline recommendations internationally.…”

Section: Preoperative Metformin Managementmentioning

confidence: 99%

Perioperative Glycemic Management for Patients with and without Diabetes

Ruzycki

Harrison

Cameron

et al. 2021

Can Journ Gen Int Med

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People with diabetes are at an increased risk for worse postoperative outcomes, compared to people without diabetes. Notably, up to one in 10 people who undergo surgery have unrecognized diabetes and an additional 10% may have postoperative hyperglycemia without meeting the criteria for a diagnosis of diabetes. Management of postoperative hyperglycemia has been demonstrated to reduce the incidence of poor outcomes, but evidence demonstrates that postoperative hyperglycemia remains a quality gap for surgical patients. In this review, we will outline the evidence for preoperative screening for postoperative hyperglycemic risk, review the evidence for perioperative glycemic management, and examine the barriers to these best practices. RÉSUMÉLes personnes atteintes de diabète courent un risque accru de voir leurs résultats postopératoires moins bons que ceux des personne non atteinte de diabète. En particulier, près d’une personne sur dix qui subit une intervention chirurgicale présente un diabète non diagnostiqué et dix pour cent supplémentaires peuvent présenter une hyperglycémie postopératoire sans pour autant répondre aux critères de diagnostic du diabète. Il a été démontré que le traitement de l’hyperglycémie postopératoire réduit l’incidence des mauvais résultats, mais les données probantes montrent que l’hyperglycémie postopératoire demeure une lacune chez les patients opérés. Dans cette revue, nous présentons les données probantes relatives au dépistage préopératoire du risque d’hyperglycémie postopératoire, nous passons en revue les données probantes relatives à la gestion de la glycémie périopératoire et nous examinons les obstacles à ces meilleures pratiques.

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Metformin monotherapy for adults with type 2 diabetes mellitus

Abstract: This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of metformin monotherapy in adults with type 2 diabetes mellitus.

Cited by 9 publications

References 66 publications

Metformin: A Narrative Review of Its Potential Benefits for Cardiovascular Disease, Cancer and Dementia

Metformin: A Narrative Review of Its Potential Benefits for Cardiovascular Disease, Cancer and Dementia

Metformin: Sex/Gender Differences in Its Uses and Effects—Narrative Review

Perioperative Glycemic Management for Patients with and without Diabetes

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