A narrative review of metformin in pregnancy: Navigating benefit and uncertainty DOI Creative Commons

Robert C. McEvoy,

Christine Newman, Aoife M. Egan

et al.

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 2, 2025

Metformin is well-established as a treatment for type 2 diabetes in non-pregnant individuals. The low cost, acceptability and broad tolerability of metformin have also made it an attractive option research into the other conditions associated with insulin resistance. Despite almost 50 years clinical experience use to treat pregnancy, many questions remain regarding its precise effectiveness different maternal subgroups, well potential short-term long-term effects on offspring. In this narrative review, we present current evidence during pregnancy various including women living overweight obesity, at risk gestational diabetes, diagnosed pregestational diabetes. Our specific focus impact maternal, fetal neonatal outcomes. We consider emerging indications such prevention management pre-eclampsia. PLAIN LANGUAGE SUMMARY: This article looks how affects mothers newborns short term. Doctors prescribed since 1970s pregnancy. use, there are still about safe effective their children. taken moves through placenta foetus's bloodstream. offspring need careful attention. studies that looked link between birth defects not found any strong taking defects, however close attention will continue be paid area. Some large examined pregnant who do but live or obesity. difficult compare. Some, all, these shown less weight gain mother if by Other whether can prevent results mostly disappointing. They suggest does stop from developing. However, participants were white backgrounds may help ethnic backgrounds. more needed. has been widely studied alternative Because countries diagnose GDM differently, makes comparing study difficult. Women seem they rather than insulin. Using instead result lower average weights babies pregnancies. Also, lead fewer being born abnormally large. Similarly, trials These show mother's needs. It control reduce having baby. One Type might increase smaller babies. was especially true had high blood pressure kidney disease. finding requires further investigation. pre-eclampsia, unclear. Research ongoing role conclusion, groups women. see benefits like better sugar/glucose control. Current suggests shouldn't used foetal growth issues. recommended Future find would benefit most metformin.

Language: Английский

Metabolic Dysfunction–Associated Steatotic Liver Disease: From Pathogenesis to Current Therapeutic Options DOI Open Access
Piero Portincasa, Mohamad Khalil, Laura Mahdi

et al.

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(11), P. 5640 - 5640

Published: May 22, 2024

The epidemiological burden of liver steatosis associated with metabolic diseases is continuously growing worldwide and in all age classes. This condition generates possible progression damage (i.e., inflammation, fibrosis, cirrhosis, hepatocellular carcinoma) but also independently increases the risk cardio-metabolic cancer. In recent years, terminological evolution from “nonalcoholic fatty disease” (NAFLD) to “metabolic dysfunction-associated (MAFLD) and, finally, steatotic (MASLD) has been paralleled by increased knowledge mechanisms linking local hepatic) systemic pathogenic pathways. As a consequence, need for an appropriate classification individual phenotypes oriented investigation innovative therapeutic tools. Besides well-known role lifestyle change, number pharmacological approaches have explored, ranging antidiabetic drugs agonists acting on gut–liver axis at level (mainly farnesoid X receptor (FXR) agonists, PPAR thyroid hormone agonists), anti-fibrotic anti-inflammatory agents. intrinsically complex pathophysiological history MASLD makes selection single effective treatment major challenge, so far. this evolving scenario, cooperation between different stakeholders (including subjects risk, health professionals, pharmaceutical industries) could significantly improve management disease implementation primary secondary prevention measures. high healthcare search new, effective, safe pressing need, together accurate characterization phenotypes. Recent promising advances indicate that we may soon enter era precise personalized therapy MASLD/MASH.

Language: Английский

Citations

21
Metformin beyond type 2 diabetes: Emerging and potential new indications DOI Creative Commons
John R. Petrie

Diabetes Obesity and Metabolism, Journal Year: 2024, Volume and Issue: 26(S3), P. 31 - 41

Published: July 4, 2024

Abstract Metformin is best known as a foundational therapy for type 2 diabetes but also used in other contexts clinical medicine with number of emerging and potential indications. Many its beneficial effects may be mediated by modest on weight loss insulin sensitivity, it has multiple mechanisms action. Current uses beyond include: polycystic ovarian syndrome; pregnancy/gestational diabetes; prevention prediabetes; adjunct 1 diabetes. As metformin been use almost 70 years, much the underpinning evidence these conditions is, definition, based trials conducted before advent contemporary evidence‐based medicine. result, some above‐established are ‘off‐label’ many regulatory territories their varies accordingly different countries. Going forward, several current ‘repurposing’ investigational being investigated: cancer (including Li Fraumeni syndrome), renal protection, Alzheimer's disease, metabolic dysfunction‐associated steatotic liver disease promotion healthy ageing. Despite longevity important roles medicine, further research ongoing.

Language: Английский

Citations

11
A Comprehensive Review of Metabolic Dysfunction-Associated Steatotic Liver Disease: Its Mechanistic Development Focusing on Methylglyoxal and Counterbalancing Treatment Strategies DOI Open Access
Izabela Berdowska, M. Matusiewicz, Izabela Fecka

et al.

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(6), P. 2394 - 2394

Published: March 7, 2025

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a multifactorial disorder characterized by excessive lipid accumulation in the which dysregulates organ’s function. The key contributor to MASLD development insulin resistance (IR) affects many organs (including adipose tissue, skeletal muscles, and liver), whereas molecular background associated with oxidative, nitrosative, carbonyl stress. Among molecules responsible for stress effects, methylglyoxal (MGO) seems play major pathological MGO—a by-product of glycolysis, fructolysis, lipolysis (from glycerol fatty acids-derived ketone bodies)—is implicated hyperglycemia, hyperlipidemia, obesity, type 2 diabetes, hypertension, cardiovascular diseases. Its causative effect stimulation prooxidative proinflammatory pathways has been well documented. Since metabolic dysregulation leading these pathologies promotes MASLD, role MGO addressed this review. Potential participation mechanism discussed regard its different signaling routes events accelerating disorder. Moreover, treatment strategies including approved potential therapies are overviewed them, medications aimed at attenuating MGO-induced processes addressed.

Language: Английский

Citations

0
A narrative review of metformin in pregnancy: Navigating benefit and uncertainty DOI Creative Commons

Robert C. McEvoy,

Christine Newman, Aoife M. Egan

et al.

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 2, 2025

Metformin is well-established as a treatment for type 2 diabetes in non-pregnant individuals. The low cost, acceptability and broad tolerability of metformin have also made it an attractive option research into the other conditions associated with insulin resistance. Despite almost 50 years clinical experience use to treat pregnancy, many questions remain regarding its precise effectiveness different maternal subgroups, well potential short-term long-term effects on offspring. In this narrative review, we present current evidence during pregnancy various including women living overweight obesity, at risk gestational diabetes, diagnosed pregestational diabetes. Our specific focus impact maternal, fetal neonatal outcomes. We consider emerging indications such prevention management pre-eclampsia. PLAIN LANGUAGE SUMMARY: This article looks how affects mothers newborns short term. Doctors prescribed since 1970s pregnancy. use, there are still about safe effective their children. taken moves through placenta foetus's bloodstream. offspring need careful attention. studies that looked link between birth defects not found any strong taking defects, however close attention will continue be paid area. Some large examined pregnant who do but live or obesity. difficult compare. Some, all, these shown less weight gain mother if by Other whether can prevent results mostly disappointing. They suggest does stop from developing. However, participants were white backgrounds may help ethnic backgrounds. more needed. has been widely studied alternative Because countries diagnose GDM differently, makes comparing study difficult. Women seem they rather than insulin. Using instead result lower average weights babies pregnancies. Also, lead fewer being born abnormally large. Similarly, trials These show mother's needs. It control reduce having baby. One Type might increase smaller babies. was especially true had high blood pressure kidney disease. finding requires further investigation. pre-eclampsia, unclear. Research ongoing role conclusion, groups women. see benefits like better sugar/glucose control. Current suggests shouldn't used foetal growth issues. recommended Future find would benefit most metformin.

Language: Английский

Citations

0