Metformin - Diabetes Drug with New Therapeutic Uses

What is Metformin?

Metformin is the first-line medication for the treatment of type-2 diabetes. It was discovered in 1922 and originates from the plant known as French lilac (Galega officinalis). Metformin is used as Metformin Hydrochloride salt and administered orally by mouth. It is the most widely used medication prescribed for diabetes. It can be prescribed in combination with other anti-diabetic medications, including Insulin.

Metformin decreases blood sugar levels by reducing glucose production by liver and increasing insulin sensitivity of cells in tissues. It decreases the absorption of glucose from the gastrointestinal tract and increases peripheral glucose intake.

What are the Uses of Metformin other than Diabetes?

Metformin has been reported to have many therapeutic effects, although its mechanism of action for uses other than diabetes is yet to be established. It has been reported to be a cure for diseases ranging from obesity to cancer.

• In addition to diabetes, Metformin is used in the treatment of polycystic ovary syndrome (PCOS).

PCOS is a hormonal disorder which could be caused due to genetic and environmental factors. The symptoms include irregularity in menstrual cycle, excess hair growth, obesity and acne. Women suffering from PCOS have insulin resistance leading to high levels of insulin. This causes ovaries to produce more of androgen hormones like testosterone. As a consequence, increased body hair, acne, irregular periods and fertility problems are seen in patients.

Metformin helps as an insulin sensitizer lowering insulin levels. It also aids in the reproductive abnormalities of PCOS syndrome by decreasing serum androgen levels. It also stimulates ovulation and helps in regularizing monthly periods.

Studies conducted at various centers have confirmed that Metformin treatment for at least six months reduces androgen levels in women suffering from PCOS syndrome.

• Metformin is also recommended to cure gestational diabetes (GD), a condition in which a woman develops diabetes during pregnancy.

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Having GD during pregnancy is a risk factor for the mother and infant. Hence, it is important to follow Metformin therapy during pregnancy in insulin resistant women in order to prevent miscarriage.

• A few clinical trials indicate that Metformin helps obese non-diabetic individuals to lose weight by reducing their appetite.

It is reported that obesity, especially with excessive fat in liver and pancreas, is one of the causes of insulin resistance. In this situation of insulin resistance, fat cells, liver cells and muscle do not respond to insulin and are unable to absorb glucose from the blood. This leads to the body producing higher levels of insulin to absorb sugar from blood. Insulin hormone acts on the brain causing hunger and hence, in these situations, the appetite of the individual increases. Metformin prevents the blood sugar levels from increasing, thus reducing the release of insulin and increasing insulin sensitivity. The patient does not fill hungry and attains weight loss.

• Scientists worldwide are also evaluating Metformin as an anti-aging drug. Studies show that Metformin increases the number of oxygen molecules in a cell, which would help increase longevity. Clinical trials to prove that Metformin slows aging process are in progress.
• A few reports indicate Metformin may prevent the cardiovascular disease and cancer complications of diabetes. It is also reported to reduce low density lipoprotein (LDL) and triglyceride levels.
• Recent studies suggest Metformin reduces the risk of open angle glaucoma.

What are the Side Effects of Metformin?

• The common side effects of Metformin include gastrointestinal irritation, flatulence, diarrhea, nausea, muscle pain and abdominal pain. Hence, Metformin must be taken with food to reduce gastro-intestinal related side effects. It is not recommended in patients with severe liver disease or kidney problems.
• Metformin has also been reported to decrease the blood levels of thyroid-stimulating hormone, in patients suffering from hypothyroidism.
• If an individual experiences severe symptoms like rash or chest pain, the doctor must be consulted immediately.

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Why is Metformin Considered Safe and Widely Recommended?

Metformin has minimal effect on weight gain, as compared to other anti-diabetics like sulfonyl ureas, which are associated with weight gain. It also has a lower risk of hypoglycemia as compared to other diabetic medications. It is also safe to consume this medicine during pregnancy.

When is Metformin Contraindicated?

• Metformin is contraindicated in patients suffering from any condition which could cause lactic acidosis. These could include liver disease, kidney disorders and lung disease.
• It is recommended that Metformin be temporarily discontinued before exposing the patient to scans involving dyes or iodinated contrast agents. The dyes may temporarily affect kidney function, leading to retention of Metformin in the body, which in turn could lead to lactic acidosis.