When Take Metformin?

Metformin is the drug of the first choice for the treatment of type 2 diabetes in adults when changes in lifestyle (diet and exercise) are not enough to control blood glucose.

This anti-diabetic drug decreases blood glucose levels at baseline –during rest and fasting- and those reached after meals. It works by reducing and delaying the amount of glucose absorbed from food at the intestinal level. It also lowers the amount of glucose produced by the liver and favors its storage as glycogen. Likewise, it increases the sensitivity of muscles and peripheral tissues to insulin, increasing the uptake and use of glucose.

It would be more antihyperglycemic than hypoglycemic. In fact, according to specialists in Diabetes, it does not affect the secretion of insulin by the pancreas, so it is a drug that does not present by itself a risk of hypoglycemia. Another use of metformin, outside the data sheet, is in women with infertility problems due to polycystic ovaries, since it improves ovulation and fertility.

Clinical Mechanisms

Metformin achieves its antihyperglycemic effect through extrapancreatic actions, especially by decreasing hepatic glucose release, along with others not yet well known (anorexigenic, decreased intestinal glucose absorption, increased number of insulin receptors, potentiation of action of the insulin).

The magnitude of the decrease in blood glucose is similar to that of sulfonylureas, both in the presence and absence of obesity. In addition, they have favorable effects on lipids (reduction of triglycerides, LDL, and total cholesterol) and do not cause weight gain (they can even cause weight loss), hyperinsulinemia or hypoglycemia.