Metformin (Glucophage) has been available in the United States since 1995 and is currently the only biguanide on the U. Metformin is now recommended as the first drug of choice for people with newly diagnosed type 2 diabetes unless there is a contraindication to it. However, metformin has been used around the world for over 60 years. In fact, it is also recommended to be started immediately upon diagnosis along with lifestyle modification. Metformin is an effective medication that works mainly by preventing the liver from producing too much glucose; however, there are other important mechanisms in the gut as well. In the normal non-diabetic state, one of the important jobs of the liver is to produce just enough glucose to keep the body functioning normally. However, in people with type 2 diabetes, the liver inappropriately overproduces glucose, mainly at night when your body is fasting. This overproduction of glucose at night leads to elevated blood glucose levels, especially in the morning. The management of T2DM requires aggressive treatment to achieve glycemic and cardiovascular risk factor goals. In this setting, metformin, an old and widely accepted first line agent, stands out not only for its antihyperglycemic properties but also for its effects beyond glycemic control such as improvements in endothelial dysfunction, hemostasis and oxidative stress, insulin resistance, lipid profiles, and fat redistribution. These properties may have contributed to the decrease of adverse cardiovascular outcomes otherwise not attributable to metformin’s mere antihyperglycemic effects. Several other classes of oral antidiabetic agents have been recently launched, introducing the need to evaluate the role of metformin as initial therapy and in combination with these newer drugs. There is increasing evidence from studies supporting its anti-proliferative role in cancer and possibly a neuroprotective effect. Metformin’s negligible risk of hypoglycemia in monotherapy and few drug interactions of clinical relevance give this drug a high safety profile. The tolerability of metformin may be improved by using an appropiate dose titration, starting with low doses, so that side-effects can be minimized or by switching to an extended release form.
This content has not been reviewed within the past year and may not represent Web MD's most up-to-date information. To find the most current information, please enter your topic of interest into our search box. 28, 2014 (Health Day News) -- People newly diagnosed with type 2 diabetes who are initially given the drug metformin are less likely to eventually need other drugs to control their blood sugar, a new study suggests. The study found that, of those started on metformin, only about one-quarter needed another drug to control their blood sugar. However, people who were started on type 2 diabetes drugs other than metformin often needed a second drug or insulin to control their blood sugar levels, the researchers said. "This study supports the predominant practice, which is that most people are started on metformin," said lead researcher Dr. Niteesh Choudhry, an associate professor of medicine at Harvard Medical School in Boston. "Metformin might be more effective than others in controlling blood sugar," he noted. A hallmark of type 2 diabetes is insulin resistance, according to the American Diabetes Association (ADA). Researchers looking at the effects of metformin and exercise in Type 2 diabetes patients found that a combination of these modalities didn't lower glucose control as much as hoped. Surprisingly, study participants showed better glucose control when sedentary. Researchers think that because metformin and exercise both act to lower glucose levels, the combination may have triggered a counter regulatory response by the body to prevent glucose levels dipping too much. It's common enough for researchers to look at the impacts of prescribed drugs on the body. And if you're a diabetes researcher who believes that exercise has great benefits for those with type 2 diabetes, you're hoping your research will show that. But when Normand Boulé looked at the dual impacts of exercise and metformin -- two of the most commonly-prescribed modalities for glucose control -- on that very outcome, the hoped-for double whammy wasn't the result. "The study had three objectives: we wanted to look at the effect of metformin on exercise in people with type 2 diabetes, examine the effect of exercise on metformin concentrations in the body, and finally to look at the effects of metformin and exercise on glucose control, which is essential for people with diabetes," says Boulé, whose study -- a randomized, double-blind, crossover study -- involved a multi-disciplinary team of researchers from five faculties at the U of A.
Feb 15, 2013. The management of T2DM requires aggressive treatment to achieve glycemic and cardiovascular risk factor goals. In this setting, metformin, an. Aug 22, 2011. Researchers looking at the effects of metformin and exercise in Type 2 diabetes patients found that a combination of these modalities didn't.