Metformin: Clinical use and update

Abstract

Metformin belongs to the family of biguanides, a group of medicines that come from guanidine, which has been used since medieval times for the treatment of diabetes. This review paper has the objective to contribute to extend its clinical use. We searched on line for original and review articles and systematic reviews from 2012-2018, or before if relevant. Metformin acts as an antihyperglycemic agent, reducing hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis, increasing glucose uptake at the muscle level and also decreasing glucose uptake at the level of the gastrointestinal tract. Intracellularly it increases anaerobic glycolysis one of its main adverse effects. Metformin is a drug that generates increased sensitivity to insulin, greater glycemic control, improved lipid profile and vascular function, it is low cost and currently the first option for the treatment of diabetes mellitus type 2.