Metformin-First Line Medication in Type II Diabetes

Metformin (aka Glucophage) is first-line therapy for patients with Type II Diabetes.

More than 120 million people worldwide take this medication!

Metformin was clinically available in the 1950's, but not available in the United States until 1995. Like many drugs, the effects were appreciated long before solid understanding of its mechanism of action. In fact, Metformin has been found beneficial in a variety of settings apart from glucose control in Type II diabetes, including diabetic nephropathy, cardiovascular disease, polycystic ovarian disease and cancer prevention.

In the realm of diabetes management, metformin improves glucose and lipid control through a variety of mechanisms:

1. decreasing hepatic (liver) glucose production
2. decreasing intestinal absorption of glucose
3. improving insulin sensitivity / reducing insulin resistance
4. increasing peripheral glucose update and utilization
5. improving lipid metabolism (reducing fatty liver disease)

A particular benefit in patients with Type II diabetes is that, except in rare circumstances, metformin does not cause hypoglycemia.

Side Effects of Metformin

Metformin is usually a very well tolerated drug. The most common side effects are GI related (nausea, diarrhea). If you take this medication and experience these side effects, please tell me!

Adverse Effects of Metformin

Lactic acidosis (usually presenting as malaise, respiratory distress, increased somnolence and abdominal discomfort) is a rare but serious complication of metformin. Someone with these symptoms while taking metformin should seek emergency care.

Overall, metformin is well tolerated and very effective in Type II Diabetes. We are fortunate to have this important drug in our toolbox of diabetes care.

If you have any questions about this medication, let's discuss them at your next visit!