Drug of the Week Series- 8: Summary of Metformin

General
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Summary of Metformin

This week, we explored Metformin, a widely prescribed Biguanide antidiabetic medication and a cornerstone in the management of Type 2 Diabetes Mellitus.

Mechanism of Action (MOA)

• Decreases hepatic glucose production (gluconeogenesis)

• Reduces intestinal absorption of glucose

• Improves insulin sensitivity in peripheral tissues, enhancing glucose uptake and utilization

Clinical Uses

  • Type 2 Diabetes Mellitus
  • PMOS/PCOS associated with insulin resistance
  • Gestational diabetes (in selected cases under medical supervision)

Role in PMOS

By improving insulin resistance, Metformin helps:

• Lower insulin and androgen levels

• Promote ovulation

• Improve menstrual regularity

• Support weight management

Common Adverse Effects

• Nausea

• Diarrhea

• Abdominal discomfort

• Loss of appetite

• Metallic taste

Serious Adverse Effect

Although rare, lactic acidosis is a potentially life-threatening complication, especially in patients with severe renal impairment.

Contraindications

• Severe kidney dysfunction (eGFR <30 mL/min/1.73m²)

• Metabolic acidosis

• Hypersensitivity to Metformin

Clinical Pearl

Metformin is often called more than just an antidiabetic drug because it targets the underlying insulin resistance, making it valuable in both diabetes and PMOS/PCOS management.

Thank you to everyone who participated in this week’s discussions, polls, and clinical challenges. Stay tuned for the next Drug of the Week!

MBH/AB

7 Likes
2

Metformin is more than a diabetes drug—it targets insulin resistance, making it valuable in both Type 2 diabetes and PCOS management.
Its long-standing safety, effectiveness, and affordability continue to make it a first-line treatment worldwide.

3

What an excellent overview!! Metformin is still one of the most extensively studied and widely used antidiabetic medications due to its promised effectiveness, safety profile, and affordability. It also benefits in improving insulin resistance highlight its importance not only in Type 2 Diabetes Mellitus but also in PMOS management. Well summarized!!

4

A tiny tablet with a giant legacy. Metformin does not promise miracles, it simply helps the body do what it was designed to do, a little better. Sometimes, the most powerful medicines are the ones that work quietly in the background.

5

Interesting how some drugs end up telling us more about disease mechanisms than we initially expected. Metformin is certainly one of them!!

6

Great summary!