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Question:
How does Metformin control blood sugar? Why is it given for majority of the patients with diabetes? Can this medicine cure diabetes?
Answer:
Metformin is an oral drug used to reduce blood glucose. Metformin exhibits its glucose lowering effect by the following mechanisms;
– reducing glucose production by the liver
– reducing insulin resistance at cellular level
– decreasing absorption of glucose from the gut
– suppressing hunger
Liver can produce glucose even at fasting state using the protein and fat stored in the body. This process is called Gluconeogenesis. This becomes exaggerated in diabetic patients. Metformin can suppress this process. [1]
Insulin resistance means that the ability of the cells to respond to insulin is impaired. In this situation, the glucose in the bloodstream cannot enter into muscle and other tissues.
Metformin is in use for more than 60 years. Majority of the patients with diabetes are suffering from Type 2 diabetes. Insulin resistance is the major component of type 2 diabetes. Due to the ability of metformin to reduce insulin resistance it is used as the first-line agent. Moreover, it is relatively cheap and available anywhere in the world. It is also listed as an essential drug by the WHO. [2] Apart from drug treatment, patients with diabetes should reduce carbohydrate intake and increase physical activity for optimum glucose control.
Metformin does not cure diabetes, but controls it. Metformin reduces incidence of some cancers as well. Common side-effects of Metformin are dyspepsia, heartburn, bloating and weight loss. In fact, weight loss is a beneficial side-effect. There is a slow-release formula of Metformin which can reduce stomach related side-effects.
References
- Graham Rena, D. Grahame Hardie, Ewan R. Pearson. 2017. “The mechanisms of action of metformin.” Diabetologia 60(9): 1577–1585. doi:10.1007/s00125-017-4342-z.
- “WHO Model List of Essential Medicines.” World Health Organisation. March, 2017. Accessed February 19, 2019. https://apps.who.int/iris/bitstream/handle/10665/273826/EML-20-eng.pdf?ua=1.