Metformin therapy and clinical uses

Abstract

Metformin is now established as a first-line antidiabetic therapy for the management of type 2 diabetes. Its early use in treatment algorithms is supported by lack of weight gain, low risk of hypoglycaemia and its mode of action to counter insulin resistance. The drug's anti-atherosclerotic and cardioprotective effects have recently been confirmed in prospective and retrospective studies, and appear to reflect a collection of glucose-independent effects on the vascular endothelium, suppressant effects on glycation, oxidative stress and formation of adhesion molecules, stimulation of fibrinolysis and favourable effects on the lipid profile. Although avoidance of troublesome gastrointestinal tolerability issues requires careful dose titration, the risk of serious adverse events is considered low provided that contra-indications (especially with respect to renal function) are observed. As many of its actions go beyond glucose lowering, emerging evidence indicates potential benefits in other insulin-resistant states and possibly tumour suppression.

Dietary Interventions to Extend Life Span and Health Span Based on Calorie Restriction

“…Metformin decreases hepatic gluconeogenesis (27,28) and increases insulin sensitivity (29). It is a potent activator of adenosine monophosphateactivated protein kinase (30) and thereby inhibits the mammalian target of rapamycin (mTOR) (31), a protein kinase that is involved in the control of cellular proliferation and is implicated in tumor growth (32,33). In mice, metformin extended mean and maximum life span in different female strains predisposed to high incidence of mammary tumors (34,35).…”

Screening and evaluation of new inhibitors of hepatic glucose production

“…in CH 2 Cl 2 (44.0 ml) was added dropwise to a solution of N,N-dimethylformamide (DMF) (18.9 ml, 244 mmol, 2.60 equiv.) in CH 2 4 and concentrated in vacuo. The residue was re-crystallized from CH 2 Cl 2 -hexane to afford 16 as a white solid.…”

“…Metformin is the only drug that acts primarily by reducing endogenous glucose production without exhibiting a major effect on insulin signaling. 2 Metformin lowers glucose levels without resulting in weight gain. Thus, it is often used to treat patients with type-2 diabetes despite the well-known safety concerns in certain diabetic patient populations and the overall high incidence of gastrointestinal intolerance associated with its use.…”

Profiles of Liver Function Tests among Type 2 Diabetic Patients Who are Receiving Different Anti-Diabetic Drugs Attending Tikur Anbessa Specialized Hospitals

“…Attention in data insertion to software on computer. The completed result was rechecked repeatedly to maintain the quality of data [66][67][68][69][70].…”