It was not until I cheked the Wiki on
metformin for the treatment of diabetes and other conditions that I found out that
metformin has been found to treat a wide range of conditions, and to extend life.
metformin
Metformin, marketed under the tradename Glucophage among others, is an antidiabetic medication which is taken by mouth. It is the first-line drug of choice for the treatment of type 2 diabetes, in particular, in overweight and obese people and those with normal kidney function.[3][4][5] Its use in gestational diabetes has been limited by safety concerns. It is also used in the treatment of polycystic ovary syndrome, and has been investigated for other diseases where insulin resistance may be an important factor such as nonalcoholic fatty liver disease. Metformin works by suppressing glucose production by the liver.[6]
Limited evidence suggests metformin may prevent the cardiovascular and possibly the cancer complications of diabetes.[7][8][9] It helps reduce LDL cholesterol and triglyceride levels and is not associated with weight gain; in some people, it promotes weight loss.[7][8] Metformin is one of only two oral antidiabetics in the World Health Organization Model List of Essential Medicines.[10]
Metformin causes few adverse effects when prescribed appropriately (the most common is gastrointestinal upset) and has been associated with a low risk of having a low blood sugar. Lactic acidosis (a buildup of lactate in the blood) can be a serious concern in overdose and when it is prescribed to people with contraindications, but otherwise, no significant risk exists.[11] It is in the biguanide class.
First made and found to reduce blood sugar in the 1920s, metformin was forgotten for the next two decades as research shifted to insulin and other antidiabetic drugs. Interest in metformin was rekindled in the late 1940s after several reports that it could reduce blood sugar levels in people, and in 1957, French physician Jean Sterne published the first clinical trial of metformin as a treatment for diabetes. It was introduced to the United Kingdom in 1958, Canada in 1972, and the United States in 1995. Metformin is now believed to be the most widely prescribed antidiabetic drug in the world; in the United States alone, more than 48 million prescriptions were filled in 2010 for its generic formulations.
Medical uses
Metformin is primarily used for type 2 diabetes, but is increasingly being used in polycystic ovary syndrome,[14] non-alcoholic fatty liver disease (NAFLD)[15] and premature puberty,[16] three other diseases that feature insulin resistance; these indications are still considered experimental. The benefit of metformin in NAFLD has not been extensively studied and may be only temporary;[17] although some randomized controlled trials have found significant improvement with its use, the evidence is still insufficient.[18][19]
Type 2 diabetes
The American Diabetes Association recommends metformin as a first-line agent to treat type 2 diabetes.[20][21]
Efficacy
The UK Prospective Diabetes Study, a large clinical trial performed in 1980-90s, provided evidence that metformin reduced the rate of adverse cardiovascular outcomes in overweight patients with type 2 diabetes relative to other antihyperglycemic agents.
Treatment guidelines for major professional associations including the European Association for the Study of Diabetes, the European Society for Cardiology, and the American Diabetes Association, now describe evidence for the cardiovascular benefits of metformin as equivocal.[21][25] According to the American College of Physicians in 2012, low-quality evidence indicates metformin monotherapy is associated with lower cardiovascular mortality than sulfonylurea monotherapy and metformin monotherapy is associated with fewer cardiovascular events than metformin-sulfonylurea combination therapy.
Metformin has little or no effect on body weight compared with placebo in type 2 diabetes,[28] although it causes weight loss compared with sulfonylureas, since sulfonylureas are associated with weight gain.[28] There is some limited evidence that metformin may be associated with weight loss in obesity in the absence of diabetes.[29] Metformin has a lower risk of hypoglycemia than the sulfonylureas,[30][31] although hypoglycemia has uncommonly occurred during intense exercise, calorie deficit, or when used with other agents to lower blood glucose.[32][33] Metformin modestly reduces LDL and triglyceride levels.
Prediabetes
Metformin treatment of people at risk for type 2 diabetes may decrease their chances of developing the disease, although intensive physical exercise and dieting work significantly better for this purpose. In a large U.S. study known as the Diabetes Prevention Program, participants were divided into groups and given either placebo, metformin, or lifestyle intervention, and followed for an average of three years. The intensive program of lifestyle modifications included a 16-lesson training on dieting and exercise followed by monthly individualized sessions with the goals to decrease the body weight by 7% and engage in a physical activity for at least 150 minutes per week. The incidence of diabetes was 58% lower in the lifestyle group and 31% lower in those given metformin. Among younger people with a higher body mass index, lifestyle modification was no more effective than metformin, and for older individuals with a lower body mass index, metformin was no better than placebo in preventing diabetes.[34] After ten years, the incidence of diabetes was 34% lower in the group of participants given diet and exercise and 18% lower in those given metformin.[35] It is unclear whether metformin slowed down the progression of prediabetes to diabetes (true preventive effect), or the decrease of diabetes in the treated population was simply due to its glucose-lowering action (treatment effect).
Gestational diabetes
Several observational studies and randomized, controlled trials have found metformin to be as effective and safe as insulin for the management of gestational diabetes.[49][50] Nonetheless, several concerns have been raised regarding studies published thus far, and evidence on the long-term safety of metformin for both mother and child is still lacking.[51]
Metformin is safe in pregnancy and women with gestational diabetes treated with metformin have less weight gain during pregnancy than those treated with insulin. Babies born to women treated with metformin have been found to develop less visceral fat, making them less prone to insulin resistance in later life.
Adverse effects
The most common adverse effect of metformin is gastrointestinal irritation, including diarrhea, cramps, nausea, vomiting, and increased flatulence; metformin is more commonly associated with gastrointestinal side effects than most other antidiabetic drugs.[31] The most serious potential side effect of metformin use is lactic acidosis; this complication is very rare, and the vast majority of these cases seem to be related to comorbid conditions, such as impaired liver or kidney function, rather than to the metformin itself.[58]
Metformin has also been reported to decrease the blood levels of thyroid-stimulating hormone in people with hypothyroidism
History
The biguanide class of antidiabetic drugs, which also includes the withdrawn agents phenformin and buformin, originates from the French lilac or goat's rue (Galega officinalis), a plant used in folk medicine for several centuries...While training at the Hôpital de la Pitié, French diabetologist Jean Sterne studied the antihyperglycemic properties of galegine, an alkaloid isolated from Galega officinalis, which is related in structure to metformin and had seen brief use as an antidiabetic before the synthalins were developed.[12] Later, working at Laboratoires Aron in Paris, he was prompted by Garcia's report to reinvestigate the blood sugar-lowering activity of metformin and several biguanide analogs. Sterne was the first to try metformin on humans for the treatment of diabetes; he coined the name "Glucophage" (glucose eater) for the drug and published his results in 1957.
Aging
As of 2015 metformin was under study for its potential effect on slowing aging in the worm C. elegans and the fruit fly.[142] Its effect on otherwise healthy humans is unknown.[142] Trials are underway including the Metformin in Longevity Study.
Homeless people cannot afford gastrointestinal upset, and especially not diarrhea, which is a common side effect of
metformin. Also, I happen to have a profound level of mistrust in medical science, because the more I study the treatment of my health and find alternatives to medicine, which do not have the side effects of commonly used medication. Consequently it has taken me 5 years to get comfortable with taking
metformin. After reading this Wiki listing on it; however, has changed my mind, and I started taking it, and plan to take it daily, and wish that I had from the onset of my type-2 diabetes. I plan to continue taking it indefinitely, or until it proves ineffective for my condition of type-2 diabetes.
