Metformin is one of the most popular oral glucose-lowering medications, widely considered to be the optimal initial therapy for patients with type 2 diabetes mellitus. Interestingly, there still remains controversy regarding the drug's precise mechanism of action, which is thought to involve a reduction in hepatic glucose production. It is now recommended as first-line treatment in various guidelines, including that of the EASD and ADA. Its favoured status lies in its efficacy, low cost, weight neutrality and good safety profile. Other benefits have also been described, including improvements in certain lipids, inflammatory markers, and a reduction in cardiovascular events, apparently independent from the drug's glucose-lowering effect. Data have emerged questioning the previous reluctance to use this agent in those with mild to moderate chronic kidney disease. Regulations guiding its use in patients with stable, modest renal dysfunction have, as a result, become more lenient in recent years. With no long-term studies comparing it against newer glucose-lowering drugs, some of which have more robust evidence for cardioprotection, metformin's established role as 'foundation therapy' in type 2 diabetes may justifiably be challenged.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00125-017-4336-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Paediatric-to-adult transition in type 1 diabetes: A two-centre experience of a structured program, 2014 to 2022.
Diabetes Obes Metab
January 2025
Endocrinologie, Diabétologie Et Gynécologie Pédiatrique, Hopital Necker-Enfants Malades, Université Paris Cité, AP-HP centre, Paris, France.
Background: Transition from paediatric to adult healthcare is a turning point for patients with Type 1 diabetes (T1D). A gradual coordinated process connecting paediatric and adult healthcare providers may improve adherence to adult follow-up.
Aims: To describe a transition process developed jointly by paediatric and adult diabetology units and compare patients progressing or not to follow-up in adult care setting.
Different Times for Different Metrics: Predicting 90 Days of Intermittently Scanned Continuous Glucose Monitoring Data in Subjects With Type 1 Diabetes on Multiple Daily Injection Therapy. Findings From a Multicentric Real-World Study.
J Diabetes Sci Technol
January 2025
Unit of Endocrine Diseases and Diabetology, Department of Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy.
Aims: According to the 2023 International Consensus, glucose metrics derived from two-week-long continuous glucose monitoring (CGM) can be extrapolated up to 90 days before. However, no studies have focused on adults with type 1 diabetes (T1D) on multiple daily injections (MDIs) and with second-generation intermittently scanned CGM (isCGM) sensors in a real-world setting.
Methods: This real-world, retrospective study included 539 90-day isCGM data from 367 adults with T1D on MDI therapy.
Patient and wound factors associated with WOUND-Q scales measuring health-related quality of life: An international cross-sectional study.
Wound Repair Regen
January 2025
Research Unit for Plastic Surgery, University of Southern Denmark, Odense, Denmark.
The WOUND-Q is a patient-reported outcome measure for individuals with any type of chronic wound. This study aimed to identify patient and wound factors associated with the four WOUND-Q health-related quality of life (HRQL) scales: Life impact, Psychological, Sleep, and Social. Adults with a chronic wound were recruited internationally through clinical settings between August 2018 and May 2020, and through an online platform (i.
View Article and Find Full Text PDFEffect of digital health applications with or without gamification on physical activity and cardiometabolic risk factors: a systematic review and meta-analysis of randomized controlled trials.
EClinicalMedicine
October 2024
Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada.
Background: Use of health applications (apps) to support healthy lifestyles has intensified. Different app features may support effectiveness, including gamification defined as the use of game elements in a non-game situation. Whether health apps with gamification can impact behaviour change and cardiometabolic risk factors remains unknown.
View Article and Find Full Text PDFNew exploration on pathogenesis and early diagnosis of gestational diabetes.
World J Clin Cases
January 2025
Department of Neurology, The Third Affiliated Hospital of Guizhou Medical University, Duyun 558099, Guizhou Province, China.
Gestational diabetes mellitus (GDM) refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients previously diagnosed with diabetes. GDM is a unique among the four subtypes of diabetes classified by the international World Health Organization standards. Although GDM patients constitute a small proportion of the total number of diabetes cases, the incidence of GDM has risen significantly over the past decade, posing substantial risk to pregnant women and infants.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!