Introduction

Metformin’s road to becoming the most prescribed glucose-lowering medicine in the world reads as an interesting biography. The drug, and others in its class, were found to have glucose-lowering effects in the 1920s, but were abandoned with the increased availability of insulin. They were then investigated as antimalarial and influenza treatments for decades before being introduced as treatment for ‘adult-onset diabetes’ in 1957.1

Metformin was considered a less-effective glucose-lowering agent than other biguanides; phenformin and buformin, but when these molecules were withdrawn from the market due to the risk of lactic acidosis, metformin remained due to a better safety profile.1

Now considered first-line treatment for type 2 diabetes mellitus (T2DM),2 metformin’s emerging use as an evidence-based treatment in other areas and investigations into its use in more novel clinical applications1 ensures that metformin’s story may continue for many years to come.

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Explain the action, efficacy and potential adverse reactions of metformin and describe the rationale for treatment in type 2 diabetes.
  • Describe the emerging role of metformin

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