Overview
Metformin is a popular drug designed to reduce blood glucose. The main purpose of Metformin is the treatment of type 2 diabetes. The drug does not increase the production of insulin by the beta cells of the pancreas and gently controls the blood sugar, GlucoNorm leading to its excessive decrease.
What is diabetes and why is it dangerous??
Diabetes mellitus is divided into two types. Type 1 diabetes is called insulin-dependent. With this type of disease, the synthesis of a special enzyme in the pancreas, insulin, which breaks down glucose, is impaired. Type 2 diabetes is called non-insulin dependent. With this type of diabetes, pancreatic function is not impaired, however, there is a decrease in sensitivity to insulin in the peripheral tissues of the body, and glucose production in the liver tissues is also increased.
Most people become ill with type 2 diabetes in old age, but recently diabetes has become noticeably “younger”. The reason for this was a sedentary lifestyle, stress, addiction to fast food and poor eating habits. Meanwhile, diabetes is a very dangerous disease, which in the absence of significant external manifestations greatly increases the risk of early heart attack and stroke, blood and vascular pathologies. Therefore, scientists have long been looking for drugs that would help lower blood sugar and not harm the body.
Description of the drug
From a chemical point of view, metformin refers to biguanides, derivatives of guanidine. In nature, guanidine is found in some plants, for example, in the goatberry medicinal, which has been used to treat diabetes since the Middle Ages. However, pure guanidine is quite toxic to the liver.
Metformin was synthesized based on guanidine back in the 20s of the last century. Already then it was known about its hypoglycemic properties, but at that time, because of the fashion for insulin, the drug was forgotten for some time. Only since the 1950s, when it became clear that insulin treatment for type 2 diabetes has many drawbacks, the drug began to be used as an antidiabetic agent and after a short time gained recognition due to its effectiveness, safety and a relatively small number of side effects and contraindications.
Today, metformin is considered the most commonly prescribed drug in the world. It is listed on the WHO Essential Medicines. It has been reliably established that regular use of metformin can reduce the risk of death from pathologies of the cardiovascular system caused by can help. Studies have shown that in people who are overweight and type 2 diabetes, treatment with metformin is 30% more effective than treatment with insulin and other antidiabetic drugs, and 40% more effective than treatment with diet alone. Compared with other antidiabetic drugs, the drug has fewer side effects, with monotherapy it practically does not cause dangerous hypoglycemia, it very rarely causes a dangerous complication - lactic acidosis (blood poisoning with lactic acid).
Metformin belongs to the class of drugs intended for the treatment of type 2 diabetes. After taking Metformin, it reduces the concentration of glucose in the blood, the level of glycosylated hemoglobin and increases the body's glucose tolerance. The drug does not have carcinogenic properties, does not affect fertility.
The mechanism of therapeutic action of metformin is versatile. First of all, it reduces the production of glucose in the liver tissues. In type 2 diabetes, glucose production in the liver is several times higher than normal. Metformin reduces this indicator by a third. This action is explained by the activation by metformin of certain liver enzymes, which play an important role in the metabolism of glucose and fats.
However, the mechanism of metformin reduction in blood glucose is not limited to suppressing the formation of glucose in the liver. Metformin also has the following effects on the body:
- improves metabolic processes,
- reduces intestinal glucose absorption ,
- improves glucose utilization in peripheral tissues,
- increases tissue sensitivity to insulin,
- has a fibrinolytic effect.
In the absence of insulin in the blood, the drug does not show its hypoglycemic activity. Unlike many other antidiabetic drugs, metformin does not lead to a dangerous complication - lactic acidosis. In addition, it does not affect the production of insulin by the cells of the pancreas. GlucoNorm, the drug is able to reduce the level of "bad" cholesterol - low density lipoproteins and triglycerides (without reducing the amount of "good" cholesterol - high density lipoproteins), reduce the rate of fat oxidation and the production of free fatty acids. Importantly, metformin levels the ability of insulin to stimulate the formation of fatty tissues, so the drug has the ability to reduce or stabilize body weight. The last property of metformin is the reason that this drug is often used by those who want to lose weight.
It should also be noted the positive effect that the drug has on the cardiovascular system. Metformin strengthens the smooth muscle walls of GlucoNorm vessels, prevents the development of diabetic angiopathy.
Pharmacokinetics
In tablets, metformin is presented as hydrochloride. It is a colorless crystalline powder, highly soluble in water.
Metformin is a relatively slow-acting drug. Usually, the positive effect of taking it begins to appear after 1-2 days. During this period, there is an equilibrium concentration of the drug in the blood, reaching 1 μg / ml. In this case, the maximum concentration of the drug in the blood can be observed already 2.5 hours after administration. The drug weakly binds to blood proteins. The half-life is 9-12 hours. It is excreted mainly by the kidneys unchanged.
People with impaired renal function may experience cumulation of the drug in the body.
Indications
The main indication for the use of the drug Metformin is type 2 diabetes. Moreover, the disease should not be complicated by ketoacidosis. It is most preferable to prescribe the drug to patients who are not helped by a low-carb diet, as well as to patients who are overweight. In some cases, the drug can be used in combination with insulin. Also, the drug can sometimes be prescribed for gestational diabetes (diabetes caused by pregnancy).
The drug can also GlucoNorm used if the person has impaired insulin tolerance, but the blood glucose values do not exceed critical values. This condition is called prediabetic. However, most specialists are inclined to believe that in this situation physical exercises and diet are more useful, and antidiabetic drugs with prediabetes are not very effective.
In addition, the drug can be prescribed for some other diseases, for example, with polycystic ovaries, non-alcoholic fatty liver pathologies, early puberty. These diseases are united by the fact that with them there is insensitivity of tissues to insulin. However, the effectiveness of metformin in these diseases does not yet have the same evidence base as in diabetes. Sometimes the drug is also used for weight loss, although official medicine treats this use of metformin with a share of skepticism, especially if it is not about people with pathologically overweight.
