Journal
ANNALS OF INTERNAL MEDICINE
Volume 137, Issue 1, Pages 25-33Publisher
AMER COLL PHYSICIANS
DOI: 10.7326/0003-4819-137-1-200207020-00009
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- NHLBI NIH HHS [R01-HL-63904-01] Funding Source: Medline
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Metformin is an insulin-sensitizing agent with potent antihyperglycemic properties. Its efficacy in reducing hyperglycemia in type 2 diabetes mellitus is similar to that of sulfonylureas, thiazolidinediones, and insulin. Metformin-based combination therapy is often superior to therapy with a single hypoglycemic agent. The anti hyperglycemic properties of metformin are mainly attributed to suppressed hepatic glucose production, especially hepatic gluconeogenesis, and increased peripheral tissue insulin sensitivity. Although the precise mechanism of hypoglycemic action of metformin remains unclear, it probably interrupts mitochondrial oxidative processes in the liver and corrects abnormalities of intracellular calcium metabolism in insulin-sensitive tissues (liver, skeletal muscle, and adipocytes) and cardiovascular tissue.
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