Vnitr Lek 2010, 56(12):1225-1227

Metformin as the first line antidiabetic agent

Š. Svačina
III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA

Metformin is considered to be the only drug suitable in patients with prediabetes and is the drug of choice in patients with type 2 diabetes. Apart from important antidiabetic effect, it also has some important additional effects: reduced incidence of tumours, positive effects on cardiovascular system, stimulation of immunity, positive effects on the bone, effect on ovulation, influence over body weight reduction, pancreas-protective effects (reduced incidence of carcinoma and possible effect on reduction in incidence of pancreatitis during incretin treatment), positive effects on liver steatosis. Since diabetes patients live with increased cardiovascular risk, it is important to continuously remind ourselves of the positive cardiovascular effects of metformin.

Keywords: metformin; cardiovascular effects; reduced risk of tumours; ovulation; liver steatosis; diabetic osteopathy

Received: November 20, 2010; Published: December 1, 2010  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Svačina Š. Metformin as the first line antidiabetic agent. Vnitr Lek. 2010;56(12):1225-1227.
Download citation

References

  1. Nathan DM, Buse JB, Davidson MB et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32: 193-203. Go to original source... Go to PubMed...
  2. Nathan DM, Davidson MB, DeFronzo RA et al. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care 2007; 30: 753-759. Go to original source... Go to PubMed...
  3. Svačina Š. Prevence diabetu a jeho komplikací. Praha: Triton 2008.
  4. Svačina Š. Systémové účinky metforminu. Postgrad Med 2010; 12: 42-45.
  5. Kalender A, Selvaraj A, Kim SY et al. Metformin, independent of AMPK, inhibits mTORC1 in a rag GTPase-dependent manner. Cell Metab 2010; 11: 390-401. Go to original source... Go to PubMed...
  6. González CR, Caminos JE, Vázquez MJ et al. Regulation of visceral adipose tissue-derived serine protease inhibitor by nutritional status, metformin, gender and pituitary factors in rat white adipose tissue. J Physiol 2009; 587: 3741-3750. Go to original source... Go to PubMed...
  7. Fischer M, McMurray J. Diabetic cardiology. Wiley: Hoboken 2010.
  8. Matsumoto K, Sera Y, Abe Y et al. Metformin attenuates progression of carotid arterial wall thickness in patients with type 2 diabetes. Diabetes Res Clin Pract 2004; 64: 225-228. Go to original source... Go to PubMed...
  9. Jyothirmayi GN, Soni BJ, Masurekar M et al. Effects of Metformin on Collagen Glycation and Diastolic Dysfunction in Diabetic Myocardium. J Cardiovasc Pharmacol Ther 1998; 3: 319-326. Go to original source... Go to PubMed...
  10. Cufí S, Vazquez-Martin A, Oliveras-Ferraros C et al. Metformin against TGFb-induced epithelial-to-mesenchymal transition (EMT): From cancer stem cells to aging-associated fibrosis. Cell Cycle 2010; 9: 4461-4468. Go to original source... Go to PubMed...
  11. Andersson C, Olesen JB, Hansen PR et al. Metformin treatment is associated with a low risk of mortality in diabetic patients with heart failure: a retrospective nationwide cohort study. Diabetologia 2010; 53: 2546-2553. Go to original source... Go to PubMed...
  12. Evans JM, Doney AS, AlZadjali MA et al. Effect of Metformin on mortality in patients with heart failure and type 2 diabetes mellitus. Am J Cardiol 2010; 106: 1006-1010. Go to original source... Go to PubMed...
  13. Aguilar D, Chan W, Bozkurt B et al. Metformin Use and Mortality in Ambulatory Patients with Diabetes and Heart Failure. Circ Heart Fail 2010; Epub ahead of print. Go to original source...
  14. Pearce EL, Walsh MC, Cejas PJ et al. Enhancing CD8 T-cell memory by modulating fatty acid metabolism. Nature 2009; 460: 103-107. Go to original source... Go to PubMed...
  15. Gras V, Bouffandeau B, Montravers PH et al. Effect of metformin on survival rate in experimental sepsis. Diabetes Metab 2006; 32: 147-150. Go to original source... Go to PubMed...
  16. Svačina Š. Diabetická osteopatie: onemocnění kdysi sporné a pravděpodobně významné. Vnitř Lék 2010; 56: 736-738. Go to PubMed...
  17. Kanazawa I. Usefulness of metformin in diabetes - related bone disease. Clin Calcium 2009; 19: 1319-1325. Go to PubMed...
  18. Lee YS, Kim YS, Lee SY et al. AMP kinase acts as a negative regulator of RANKL in the differentiation of osteoclasts. Bone 2010; 47: 926-937. Go to original source... Go to PubMed...
  19. Tang T, Lord JM, Norman RJ et al. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev 2010; 1: CD003053. Go to original source... Go to PubMed...
  20. Currie CJ, Poole CD, Gale EA. The influence of glucose-lowering therapies on cancer risk in type 2 diabetes. Diabetologia 2009; 52: 1766-1777. Go to original source... Go to PubMed...
  21. Libby G, Donnelly LA, Donnan PT et al. New users of metformin are at low risk of incident cancer: a cohort study among people with type 2 diabetes. Diabetes Care 2009; 32: 1620-1625. Go to original source... Go to PubMed...
  22. Bodmer M, Meier C, Krähenbühl S et al. Long-term metformin use is associated with decreased risk of breast cancer. Diabetes Care 2010; 33: 1304-1308. Go to original source... Go to PubMed...
  23. Haluzík M, Svačina Š. Inkretinová léčba diabetu. Praha: Mladá fronta 2010.
  24. Li D, Abbruzzese JL. New strategies in pancreatic cancer: emerging epidemiologic and therapeutic concepts. Clin Cancer Res 2010; 16: 4313-4318. Go to original source... Go to PubMed...
  25. Levri KM, Slaymaker E, Last A et al. Metformin as treatment for overweight and obese adults: a systematic review. Ann Fam Med 2005; 3: 457-461. Go to original source... Go to PubMed...
  26. Rakoski MO, Singal AG, Rogers MA et al. Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2010; 32: 1211-1221. Go to original source... Go to PubMed...
  27. Bell DS. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy. South Med J 2010; 103: 265-267. Go to original source... Go to PubMed...
  28. Chen Y, Zhou K, Wang R et al. Antidiabetic drug metformin (Glucophage®) increases biogenesis of Alzheimer's amyloid peptides via up-regulating BACE1 transcription. Proc Natl Acad Sci USA 2009; 106: 3907-3912. Go to original source... Go to PubMed...




Vnitřní lékařství

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.