Metformin’s origins trace back to the herb Galega officinalis (goat’s rue), which was historically used to manage diabetes symptoms in medieval Europe. The drug was first approved in 1957 in France, and it was revolutionary because it could lower glucose without the typical risks of low blood sugar present in other glucose-lowering medications at the time.
How Metformin Works
Metformin primarily lowers blood glucose by reducing liver glucose production, a critical factor in type 2 diabetes. It also enhances insulin sensitivity, increasing glucose uptake and utilization in peripheral tissues, especially muscles. Moreover, Metformin mildly inhibits glucose absorption in the intestines, further aiding in blood sugar control. Its unique mechanism does not stimulate insulin secretion, significantly reducing the risk of hypoglycemia and making it suitable for a wide range of patients, including those who are overweight or obese, as it can support modest weight loss.
Clinical Benefits of Metformin
Today, Metformin is considered the first-line medicine for the treatment of type 2 diabetes. It can reduce HbA1c levels by approximately 1.5% to 2%, making it one of the most potent oral treatments available. Metformin alone can control 2/3 of cases of type 2 diabetes mellitus.
Comparative Analysis: Metformin vs Sulfonylureas in Diabetes Management
When analyzing data from around 200,000 individuals, it was observed that individuals who were treated with Metformin for type 2 diabetes lived, on average, seven years longer than individuals treated with sulfonylureas. The article suggests that neither medicine allows a type 2 diabetic to live as long as a healthy individual; however, Metformin is able to bring the lifespan much closer to that of a non-diabetic individual than sulfonylureas.
Cardiovascular and Cancer Risks
Sulfonylurea users in monotherapy demonstrated a higher likelihood of developing cardiovascular disease (CVD) by approximately 4.5%. Furthermore, individuals treated with Metformin over sulfonylureas exhibit a 6 percent decrease in the probability of overall risk of death from cardiovascular causes.
Practical Information for Patients for Metformin
Metformin uses up an individual’s vitamin B12 levels. Therefore, patients should regularly supplement vitamin B12 and have their vitamin B12 levels tested annually. Also, it is not unusual to have some GI disturbances while on Metformin; however, in most cases, these effects are minor and are transient for approximately two to three months.
Metformin is better tolerated when an individual has a diet that is low in carbohydrates as Metformin has some effects on the intestines that reduce the efficiency of carbohydrates entering the bloodstream through the spelling test scenes; however, the extra because the glucose will make its way into the large intestine which is osmotically active and may cause diarrhea if there are lots of glucose-containing foods consumed by the patient.
Key Takeaways
Metformin monotherapy is more beneficial than sulfonylurea monotherapy based on the data above. It is essential to understand the study’s limitations, as they were observational rather than clinical trials; however, the large data set analyzed provides valuable information. Furthermore, it is essential to understand that sulfonylureas are added to Metformin in cases where glucose is not adequately controlled in most modern medical practices. Also, from a practical point of view, from a patient’s perspective, this information is relevant if they are being treated with antidiabetic medications without also failing metformin monotherapy to control their HBA1C.
