Home > Metformin (Molecule of the Month for March 2000 )

Picture of Metformin

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Picture of Metformin

Metformin is a drug used in the treatment of diabetes, one in a group of diabetes medicines called biguanides. Metformin is an oral medication designed to help control elevated blood sugar levels in NIDDM (non-insulin-dependant diabetes mellitus). It is believed to work by inhibiting hepatic glucose production and increasing the sensitivity of peripheral tissues to insulin. Metformin’s brand name is Glucophage and it has been used clinically in Europe continually since 1970. However, in America in 1977 the drug was removed from the U.S market amid safety concerns about the related drug Phenformin. This was seen to occasionally promote lactic acidosis, a potentially fatal build-up of lactic acid in the blood.

The medicine does not increase how much insulin the pancreas makes but acts on the liver preventing it from producing excess sugar and stopping hyperglycemia (high blood sugar). Metformin is primarily suited for the treatment of subjects with non-insulin-dependent diabetes mellitus (Type II diabetes). Compared to other antidiabetic agents, it has the advantages of lowering rather than increasing body weight, of not causing hypoglycemia, and of entailing a reduction of triglycerides and LDL-cholesterol levels. Metformin is therefore recommended in single drug therapy especially for obese subjects. In the majority of the treated subjects a lowering of blood glucose levels by at least 25% is achieved (i.e. almost identical results as with sulfonylureas at the beginning of treatment).

Metformin also helps lower the fatty blood components triglycerides and cholesterol that are often high in people with Type II diabetes. In December 1994, the U.S. Food and Drug Administration (FDA) approved the use of metformin for the treatment of Type 2 diabetes. Metformin was approved for use either alone or with sulfonylureas, a commonly used group of diabetes medicines. Metformin's brand name is Glucophage. Metformin can also be combined with other antidiabetic agents. It can thus e.g. be used when there is secondary failure with sulfonylureas. Occasionally a small dose of metformin combined with a sulfonylurea is sufficient to restore an adequate diabetic control. In carefully selected cases, a combination with insulin can also be sensible - particularly for obese subjects with relative insulin resistance.

Formal Chemical Name (IUPAC)

Update by Karl Harrison
(Molecule of the Month for March 2000 )