Diabetes Mellitus:  Lipids

 

Introduction

Metformin (Glucophage) is a synthetic analog of the natural product guanidine, whose history as a treatment for diabetes can be traced to medieval times.  It is currently the most common drug used as treatment for diabetes in the United States.  Phenformin, a structurally similar analog of metformin, was previously withdrawn from the market in many countries due its propensity to induce lactic acidosis. Metformin rarely causes lactic acidosis.  It  is recommended as a first-line therapy in newly diagnosed individuals, and can be used in combination with an insulin secretagogue (sulfonylurea or meglitinide), thiazolidinedione, a-glucosidase inhibitor, or insulin

Mechanism of Action

Metformin suppresses basal hepatic glucose production, thereby reducing fasting plasma glucose.  Despite the large number of studies both in vitro and in humans that have established this mode of action, the molecular target of metformin action is still unknown. Metformin does not stimulate insulin secretion; in contrast, metformin reduces fasting plasma insulin and improves whole-body insulin-stimulated glucose metabolism (insulin sensitivity).

Section  Details:

Introduction

Mechanism of Action

Efficacy

Side Effects

Dosing

Required Screens:  4
Optional Screens:   4