(Disclaimer: This post is not intended to be a prescription/medical advice).
Metformin is the most commonly prescribed OHA (oral hypoglycemic agent)- a class of drugs that reduce blood glucose levels.
It is the first line of treatment in Type 2 diabetes mellitus (T2DM). In T2DM, the main issue is that there is excess blood glucose and the body becomes resistant to insulin, even though insulin production (which is done by the pancreas) may be normal.
[On the contrary, in Type 1 diabetes mellitus, the main issue is that there is destruction of pancreatic tissue by the body’s own immune mechanism- a disease process known as autoimmunity. Because of this, insulin PRODUCTION itself is hampered. Hence, the main treatment in T1DM is insulin, and not oral antidiabetic drugs].
Metformin acts by three main mechanisms. It-
•decreases glucose production in the liver
•decreases glucose absorption
•increases the body’s sensitivity to insulin.
As with most drugs, metformin has its adverse effects- these include gastrointestinal upset and more severely, lactic acidosis (buildup of lactic acid in the blood). Another important side effect is Vitamin B12 deficiency; which is why Vitamin B12 is usually given concurrently with metformin.
QUESTION: What other oral antidiabetic drug have you heard of?
Metformin is a Biguanide, other categories of OHAs are Sulfonylurea, DPP-4 inhibitors, GLP-1 analogue, SGLT-2 inhibitors. The very famous drug these days among celebrities is “Ozempic” (Semaglutide), which belongs to GLP-1 analogue group, it has a side effect of weight loss. So its this side effect property is being employed for weight loss among obese patients. But it should be cautiously used.
Very well explained! Metformin in Type 2 diabetes management is safe, affordable, and has long-term benefits. Other oral antidiabetic drug classes are Sulfonylureas like glimepiride and glipizide, DPP-4 inhibitors such as sitagliptin and vildagliptin, and SGLT2 inhibitors; each class with its own unique benefits and is often patient-tailored..
This is a great explanation of how metformin works. Many people take it without really knowing how it helps their body use insulin better. The point about B12 deficiency is important too, since it often gets overlooked in long-term therapy.
There are many classes of anti-diabetic agents, and metformin belongs to the class of biguanides. Some of the other examples are:
Sulfonylureas - glipizide
Meglitinides - repaglinide
Thiazolidinediones - rosiglitazone
SGLT2 inhibitors - dapagliflozin
Metformin is one of the most commonly prescribed drugs for managing type 2 diabetes. It is sometimes used in combination with sulfonylureas to achieve better blood sugar control. However, in recent times, there has been a concerning trend involving the misuse of GLP-1 analogue drugs, such as Ozempic, which are primarily meant for diabetes management. Many celebrities have been reportedly using these medications for rapid weight loss.
Metformin truly stands out as the backbone of Type 2 diabetes management because of its multi-targeted action and strong safety profile. Its ability to reduce hepatic glucose output, slow intestinal absorption, and improve insulin sensitivity makes it unique among OHA drugs.
Metformin truly is the backbone of Type 2 diabetes care, and you’ve explained its role so clearly. Along with it, drugs like sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 analogues are also becoming quite common in diabetes management.
Such a clear and well-structured explanation of how metformin works and why it remains the backbone of T2DM management. The link you drew between its mechanisms, side effects, and the need for B12 supplementation is great. Apart from metformin, I’ve often heard about sulfonylureas like glimepiride and newer agents such as DPP-4 inhibitors (e.g., sitagliptin) and SGLT2 inhibitors (e.g., empagliflozin), which are becoming increasingly important in diabetes care.