Metformin: An Update

  title={Metformin: An Update},
  author={Dmitri Kirpichnikov and Samy I McFarlane and James R. Sowers},
  journal={Annals of Internal Medicine},
Insulin resistance contributes greatly to development of cardiovascular disease in patients with the metabolic syndrome and its extreme presentation, type 2 diabetes mellitus. Therefore, treatment with an insulin-sensitizing agent, such as metformin, in patients with type 2 diabetes mellitus may correct several of the primary pathophysiologic abnormalities of the metabolic syndrome. In diabetic patients, metformin appears to provide cardiovascular protection that cannot be attributed only to… 

Use of Metformin in Patients with Kidney and Cardiovascular Diseases

The use of metformin in patients with kidney disease, a high-risk CVD state, is confounded by confusion regarding appropriate concerns about the development of lactic acidosis in this population.

Treatment update: thiazolidinediones in combination with metformin for the treatment of type 2 diabetes

The clinical data behind the use of metformin in combination with TZDs for the management of diabetes, its impact on vascular health, side effects and potential mechanisms of action for combined use are reviewed.

Metformin: new understandings, new uses.

The role of metformin in the treatment of patients with type 2 diabetes and its potential role for a variety of insulin resistant and prediabetic states, including impaired glucose tolerance, obesity, polycystic ovary syndrome and the metabolic abnormalities associated with HIV disease are reviewed.

Metabolic syndrome therapy: Prevention of vascular injury by antidiabetic agents

The oral agents used to treat type 2 diabetes and the metabolic syndrome, and their effects on vascular tissue are reviewed, including metformin, thiazolidinediones, which target insulin resistance.

Insulin Sensitizers and Cardiovascular Disease

Thiazolidinediones (TZDs) decrease IR primarily at the level of the muscles, thereby increasing glucose uptake and decreasing plasma glucose and may improve insulin sensitivity by decreasing the plasma free fatty acid concentration (FFA).

A preclinical overview of metformin for the treatment of type 2 diabetes.

A Review on Metformin: Clinical Significance and Side Effects

Its ability to improve insulin sensitivity and the cardiovascular risk profile of type II diabetic patients has enhanced its clinical use as first-line therapy and its good safety profile, efficacy and comparatively reduced cost.

Individualized Therapy for Type 2 Diabetes

The current understanding of genetic polymorphisms that may affect the responses of subjects with T2DM to antidiabetic treatment is summarized and three major classes of genes involved in drug metabolism and transporters that influence pharmacokinetics are summarized.

Metformin, beyond an insulin sensitizer, targeting heart and pancreatic β cells.




An overview of metformin in the treatment of type 2 diabetes mellitus.

The antihyperglycaemic effect of metformin: therapeutic and cellular mechanisms.

Metformin improves hepatic and peripheral sensitivity to insulin, with both direct and indirect effects on liver and muscle, which collectively reduce insulin resistance and glucotoxicity in type 2 diabetes.

Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group.

Metformin monotherapy and combination therapy with metformin and sulfonylurea are well tolerated and improve glycemic control and lipid concentrations in patients with NIDDM whose diabetes is poorly controlled with diet or sulfonyLurea therapy alone.

Efficacy and metabolic effects of metformin and troglitazone in type II diabetes mellitus.

Metformin and troglitazone have equal and additive beneficial effects on glycemic control in patients with type 2 diabetes.

Combining sulfonylureas and other oral agents.

  • M. Riddle
  • Medicine
    The American journal of medicine
  • 2000

Acute Antihyperglycemic Mechanisms of Metformin in NIDDM: Evidence for Suppression of Lipid Oxidation and Hepatic Glucose Production

The specific, antihyperglycemic effects of metformin in the clinical condition of hyperglycemia in NIDDM are primarily due to suppression of HGP, not stimulation of glucose uptake, and are mediated, at least in part, by suppression of FFA and lipid oxidation.

Mechanism by which metformin reduces glucose production in type 2 diabetes.

Patients with poorly controlled type 2 diabetes have increased rates of endogenous glucose production, which can be attributed to increased levels of gluconeogenesis, according to the differences between the two methods used.

Effect of metformin and rosiglitazone combination therapy in patients with type 2 diabetes mellitus: a randomized controlled trial.

The data suggest that combination treatment with once-daily metformin-rosiglitazone improves glycemic control, insulin sensitivity, and beta-cell function more effectively than treatment with met formin alone.

Diabetes mellitus and diabetes-associated vascular disease