二甲双胍
双胍
糖尿病前期
医学
2型糖尿病
胰岛素抵抗
糖尿病
2型糖尿病
药理学
内科学
内分泌学
重症监护医学
生物信息学
生物
摘要
Abstract Metformin (dimethyl‐biguanide) can claim its origins in the use of Galega officinalis as a plant treatment for symptoms ascribed to diabetes. Since the first clinical use of metformin as a glucose‐lowering agent in 1957, this medicine has emerged as a first‐line pharmacological option to support lifestyle interventions in the management of type 2 diabetes (T2D). It acts through multiple cellular pathways, principally in the gut, liver and muscle, to counter insulin resistance and lower blood glucose without weight gain or risk of overt hypoglycaemia. Other effects include improvements in lipid metabolism, decreased inflammation and lower long‐term cardiovascular risk. Metformin is conveniently combined with other diabetes medications, can be prescribed in prediabetes to reduce the risk of progression to T2D, and is used in some regions to assist glycaemic control in pregnancy. Consistent with its diversity of actions, established safety profile and cost‐effectiveness, metformin is being assessed for further possible clinical applications. The use of metformin requires adequate renal function for drug elimination, and may cause initial gastrointestinal side effects, which can be moderated by taking with meals or using an extended‐release formulation. Thus, metformin serves as a valuable therapeutic resource for use throughout the natural history of T2D.
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