Metformin protects heart and pancreatic β cells in addition to its improved insulin sensitivity in the primary insulin-targeted organs, such as liver, fat and muscle. Metformin takes pleiotropic actions and exerts a protective effect from cardiovascular disease and heart failure.
Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood.
Metformin protects the kidneys mainly via AMP-activated protein kinase (AMPK) signaling and AMPK-independent pathways. AMPK is a well-known energy and nutrient sensor, which regulates the switch from anabolic to catabolic metabolism to control energy homeostasis [13].
Metformin lowers your blood sugar levels by improving the way your body handles insulin. It's usually prescribed for diabetes when diet and exercise alone have not been enough to control your blood sugar levels.
Conclusion: Metformin does not appear to cause or exacerbate liver injury and, indeed, is often beneficial in patients with nonalcoholic fatty liver disease. Nonalcoholic fatty liver frequently presents with transaminase elevations but should not be considered a contraindication to metformin use.
According to various studies, metformin therapy in patients suffering from NAFLD causes weight loss, reduction of liver transaminases, better histology of liver (reduction of liver steatosis and inflammatory necrosis), improvement of insulin sensitivity and reduction of liver fibrosis (12–14).
Long-term side effects
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
If your kidneys don't function properly, there's concern that metformin can build up in your system and cause a condition called lactic acidosis. Lactic acidosis is when there's a dangerous amount of lactic acid in the body.
For decades we've known that metformin does more than just help lower blood sugar in people with diabetes. It also offers them cardiovascular benefits, including lower rates of death due to cardiovascular disease. And it sometimes helps people with diabetes lose excess weight.
Metformin promotes pancreatic β cell functions
1). Metformin exerts direct beneficial effects on β cell function such as insulin release, transcriptional regulation in pancreatic islets, and islet cell viability, being dependent on the presence of glucose [101].
Metformin can significantly reduce mortality and reduce the incidence of cardiovascular events, that means metformin can be used as a cardiovascular protective agent to prolong life and reduce mortality.
Due to its inhibitory effect on the proinflammatory phenotype of immune cells, metformin seems to reduce auto-immune disease burden not only in several animal models, but has also shown beneficial results in some human trials.
Kidney damage may begin 10 to 15 years after diabetes starts. As damage gets worse, the kidneys become worse at cleansing the blood. If the damage gets bad enough, the kidneys can stop working. Kidney damage can't be reversed.
Griebeler says that even though metformin is only approved for the treatment of type 2 diabetes, it's being used off-label to treat weight reduction, polycystic ovarian syndrome (PCOS), infertility, prevention of diabetes, prevention of pregnancy complications, and obesity.
The use of metformin by non-diabetics stems from some evidence that metformin can decrease inflammation, protect against cardiovascular disease and cognitive impairment, minimize cancer risk and progression, and prolong life.
Recent preclinical and clinical studies have suggested that metformin not only improves chronic inflammation through the improvement of metabolic parameters such as hyperglycemia, insulin resistance and atherogenic dyslipidemia, but also has a direct anti-inflammatory action.
Chances are, you doctor will have you take metformin for at least a year. This is because it takes about 3 months for your HbA1C to change, and those changes are usually very gradual. If your fasting blood sugar and HbA1C drop to the normal range, your doctor may take you off metformin and see how you do without it.
Medications used by people with diabetes such as Glipizide and Metformin may cause changes to the oral cavity, such as candidiasis, burning mouth, xerostomia, and the chance of getting periodontal disease and caries.
Metformin, a drug approved by the U.S. Food and Drug Administration (FDA) for use in patients with diabetes, has been shown to improve fatty liver in animals and in a small number of human beings. Other Names: metformin.
Clinically apparent liver injury from metformin is very rare, fewer than a dozen cases having been described in the literature despite widespread use of this agent for several decades. The liver injury usually appears after 1 to 8 weeks, typically with symptoms of weakness and fatigue followed by jaundice.
Five studies showed that metformin treatment for 12 to 24 weeks reduced the body mass index (BMI), liver fat content, liver enzymes, and hemoglobin A1c (HbA1c) and improved insulin resistance in NAFLD patients with type 2 diabetes mellitus (T2DM).
We bring you some of the newest findings on finerenone, Jardiance, and Farxiga – three medications that have been shown to protect the kidneys in people with decreased kidney function, including those with diabetes and CKD.
Metformin is contraindicated when the eGFR is <30 mL/min/1.73 m2. Renal function should be evaluated prior to any ICM-related procedures.