Metformin

doi:10.1056/NEJM199602293340906

Volume 334:574-579		February 29, 1996		Number 9

Metformin

Clifford J. Bailey, Ph.D., M.R.C.Path., and Robert C. Turner, M.D.

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Metformin (dimethylbiguanide) is an orally administered drugused to lower blood glucose concentrations in patients withnon-insulin-dependent diabetes mellitus (NIDDM).¹ It improvesinsulin sensitivity and thus decreases the insulin resistancethat is prevalent in NIDDM. The efficacy of glycemic controlachieved with metformin is similar to that achieved with sulfonylureas,although their modes of action differ. Metformin can be usedeither as initial therapy or as an additional drug when sulfonylureatherapy alone is inadequate. In this article we shall discussthe pharmacology and clinical use of metformin, which is nowavailable in the United States.

The Burden of Non-Insulin-Dependent Diabetes Mellitus

An estimated 12 million . . . [Full Text of this Article]

The Effects of Improved Glycemic Control

The Pathophysiology of Non-Insulin-Dependent Diabetes Mellitus

Healthful Living and Its Limitations

Sulfonylurea Therapy and Its Limitations

History of Biguanides

Mechanisms of Action of Metformin

Comparison of Sulfonylurea and Metformin Therapy

Initiating and Monitoring Therapy with Metformin

Lactic Acidosis

Use of Metformin Therapy during Intervening Illnesses

Conclusions

Source Information

From the Department of Pharmaceutical and Biological Sciences, Aston University, Birmingham (C.J.B.), and the Diabetes Research Laboratories, Radcliffe Infirmary, Oxford (R.C.T.) — both in the United Kingdom.

Address reprint requests to Dr. Bailey at the Department of Pharmaceutical and Biological Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, United Kingdom.

References

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