View on Metformin: Antidiabetic and Pleiotropic Effects, Pharmacokinetics, Side Effects, and Sex-Related Differences

Pharmaceuticals, Journal Year: 2024, Volume and Issue: 17(4), P. 478 - 478

Published: April 8, 2024

Metformin is a synthetic biguanide used as an antidiabetic drug in type 2 diabetes mellitus, achieved by studying the bioactive metabolites of Galega officinalis L. It also off-label for various other diseases, such subclinical diabetes, obesity, polycystic ovary syndrome, etc. In addition, metformin proposed add-on therapy several conditions, including autoimmune neurodegenerative and cancer. Although has been many decades, it still subject pharmacodynamic pharmacokinetic studies light its extensive use. acts at mitochondrial level inhibiting respiratory chain, thus increasing AMP/ATP ratio and, subsequently, activating AMP-activated protein kinase. However, mechanisms have proposed, binding to presenilin enhancer 2, GLP1 release, modification microRNA expression. Regarding pharmacokinetics, after oral administration, absorbed, distributed, eliminated, mainly through renal route, using transporters cationic solutes, since exists ionic molecule physiological pH. this review, particular consideration paid literature data from last 10 years, deepening study clinical trials inherent new uses metformin, differences effectiveness safety observed between sexes, unwanted side effects. For objective, was evaluated both VigiBase EudraVigilance, respectively, WHO European databases reported adverse reactions, assess extent effects real-life

Language: Английский

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Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(8), P. 2176 - 2176

Published: April 10, 2024

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop widely accepted expert consensus guide the practice of diagnosing treating deficiency. Methods: conducted scoping review literature published PubMed since January 2003. Data were used design two-round Delphi survey study level among 42 experts. Results: The panelists agreed on need for educational organizational changes current medical practices Recognition clinical symptoms should receive highest priority establishing diagnosis. There is agreement that serum concentration useful as screening marker methylmalonic acid or homocysteine support Patient lifestyle, disease history, medications provide clues Regardless deficiency, initial treatment with parenteral was regarded first choice patients acute severe manifestations use high-dose oral at different frequencies considered long-term treatment. Prophylactic supplementation specific high-risk groups. Conclusions: more attention diagnosis laboratory markers severity causes goals govern decisions regarding route dose therapy.

Language: Английский

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The effect of metformin on peripheral nerve morphology in type 2 diabetes: a cross-sectional observational study

Diabetes, Journal Year: 2024, Volume and Issue: 73(11), P. 1875 - 1882

Published: Aug. 21, 2024

Diabetic peripheral neuropathy (DPN) affects ∼50% of the 500 million people with type 2 diabetes worldwide and is considered disabling irreversible. The current study was undertaken to assess effect metformin on outcomes in diabetes. Participants (n = 69) receiving were recruited underwent clinical assessment, nerve ultrasonography, conduction studies, axonal excitability studies. Also concurrently screened 318 participants who not metformin, 69 selected as disease control subjects matched for age, sex, duration, BMI, HbA1c, use other therapies. Medical record data over previous 20 years analyzed use. Mean tibial cross-sectional area lower group (metformin 14.1 ± 0.7 mm2, nonmetformin 16.2 0.9 P 0.038), accompanied by reduction symptom severity (P 0.021). Axonal studies demonstrated superior function group, mathematical modeling that these improvements mediated changes nodal Na+and K+conductances. Metformin treatment associated structure neurophysiological measures. Treatment may be neuroprotective DPN. Article Highlights

Language: Английский

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Diagnosis, Treatment and Long-Term Management of Vitamin B12 Deficiency in Adults: A Delphi Expert Consensus

Published: April 9, 2024

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop widely accepted expert consensus guide the practice of diagnosing treating deficiency. Methods: conducted scoping review literature published PubMed since January 2003. Data were used design two-round Delphi survey study level among 42 experts. Results: The panelists agreed on need for educational organizational changes current medical practices Recognition clinical symptoms should receive highest priority establishing diagnosis. There is agreement that serum concentration useful as screening marker, whereas methylmalonic acid or homocysteine support Patient lifestyle, disease history medications provide clues Regardless deficiency, initial treatment with parenteral was regarded first choice patients acute severe manifestations use high-dose oral at different frequencies considered long-term treatment. Prophylactic supplementation specific high-risk groups. Conclusions: more attention laboratory markers severity causes goals govern decisions regarding route dose therapy.

Language: Английский

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Dose dependent relationship of metformin use and diabetic peripheral neuropathy risk in patients with type 2 diabetes mellitus

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: April 8, 2025

This study investigated the correlation between metformin use and diabetic peripheral neuropathy (DPN) risk in patients with type 2 diabetes mellitus (T2DM) its dose-dependent relationship. The included new-onset T2DM from 2002 to 2013. Patients were divided into two groups based on treatment, DPN was assessed at 2- 5-year follow-ups. After adjusting for various factors, logistic models, cumulative defined daily dose (cDDD) treatment intensity (defined [DDD]/month), evaluated metformin-DPN association. Results showed that cDDD < 300, 300-500, > 500 had higher both Odds ratios (ORs) confidence intervals (CIs) 1.74 (1.69-1.79), 2.05 (1.81-2.32), 2.36 (1.34-4.16) years 1.63 (1.60-1.65), 1.82 (1.69-1.96), 2.17 (1.56-3.03) 5 years. Similarly, 10, 10-25, 25 DDD/month Metformin correlated patients, a Higher or increased risk. However, absence of vitamin B12 data limits understanding underlying mechanisms. Well-designed, large-scale studies are required evaluate potential risks therapy T2DM.

Language: Английский

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Application Value of Electromyography Combined With Heart Rate Variability in the Diagnosis of Diabetic Peripheral Neuropathy

Published: April 24, 2025

Purpose: To explore the clinical value of Electromyography (EMG) and Heart Rate Variability (HRV) in diagnosis early DPN provide basis for diagnosis, treatment, prevention DPN. Methods: 105 patients with type 2 diabetes mellitus (T2DM) Changji People’s Hospital were treated from January 2023 to December 2023. They stratified into DPN-symptomatic (DPN group, n=55) DPN-asymptomatic (NDPN n=50) cohorts based on presence or absence clinically confirmed diabetic peripheral neuropathy. The biochemical indicators, nerve electromyography, HRV parameters obtained electronic medical records, differences detection results compared between two groups. Logistic regression was applied analyze influencing factors patients. receiver operating characteristic (ROC) curve diagnostic EMG combined other Results: From general information, duration, glycosylated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), total (TC) FBG group significantly NDPN (p<0.05). There no statistically significant gender, age years, uric acid, data (p>0.05). Compared motor conduction velocity (MNCV), sensory (SNCV) ulnar nerve, median tibial had higher average F wave latency H tested statistical significance decreased (SDNN, rMSSD, PNN50, SDANN, all p <0.05). ROC analysis showed that area under (AUC) by duration diabetes, HbA1c, EMG, accuracy 82.86%, sensitivity 78.00 . AUC four than each alone Conclusion: combination has a high assessment can be used extent lesion.

Language: Английский

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Metformin-Induced Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Narrative Review with a Practical Approach for Screening, Diagnosing, and Managing Vitamin B12 Deficiency

Korean Journal of Family Medicine, Journal Year: 2024, Volume and Issue: 45(4), P. 189 - 198

Published: July 18, 2024

Metformin is the most widely used antihyperglycemic drug in patients with type 2 diabetes (T2D). Over past decades, several studies have highlighted a substantial increase risk of vitamin B12 deficiency T2D on metformin therapy. This can lead to complications and induce or exacerbate peripheral neuropathy. Despite these data, there are no definite guidelines for screening, diagnosing, treating Therefore, this narrative review, we aimed suggest practical diagnostic therapeutic strategy address receiving treatment. Clinical evidence supporting an increased therapy its factors potential also discussed.

Language: Английский

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Rethinking about Metformin: Promising Potentials

Korean Journal of Family Medicine, Journal Year: 2024, Volume and Issue: 45(5), P. 258 - 267

Published: Aug. 26, 2024

Metformin is widely used drugs in the treatment of type 2 diabetes mellitus. However, mechanisms action are complex and still not fully understood yet. has a dose-dependent blood sugar-lowering effect. The most common adverse reactions metformin gastrointestinal symptoms, women tend to be more experienced than men. A positive correlation between administration duration daily dose risk vitamin B12 deficiency confirmed. Novel glucose-lowering mechanism through activation AMP-activated protein kinase alteration gut microbiota composition identified. In addition, immunomodulatory properties various mechanisms, including anti-inflammatory actions, so forth. improves insulin sensitivity, which may reduce tumor growth certain cancers. antiviral effects occur several blocking angiotensin converting enzyme receptor, These potential promising clinical settings, such as inflammatory diseases, autoimmune cancer, coronavirus disease 2019.

Language: Английский

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Association of Metformin Use with Iron Deficiency Anemia in Urban Chinese Patients with Type 2 Diabetes

Nutrients, Journal Year: 2023, Volume and Issue: 15(14), P. 3081 - 3081

Published: July 8, 2023

Background: Previous evidence yielded contradictory findings on the relationship between metformin and anemia. This study aims to assess whether use is associated with iron-deficiency anemia (IDA) risk in patients type 2 diabetes (T2D) Beijing, China. Methods: Overall, 60,327 newly diagnosed T2D were included based a historical cohort design. The information pertaining these was gathered from Beijing Medical Claim Data for Employees Database. These then categorized into non-metformin groups matched 1:1 propensity score their initial antidiabetic prescription. Cox proportional hazards models utilized calculate incidences hazard ratios (HRs). Results: enrolled 27,960 diabetes, 13,980 each of glucose-lowering prescription groups: non-metformin. During median follow-up period 4.84 years, 4832 developed IDA. incidence IDA significantly lower group (26.08/1000 person-years) than (43.20/1000 person-years). Among three divided by proportion days covered metformin, we found negative correlation <20%, 20–79%, ≥80% 0.43 (0.38, 0.48), 0.37 (0.34, 0.42), 0.91 (0.85, 0.98), respectively, compared group. We also performed subgroup analyses sensitivity analyses: that all subgroups, protective effect more significant subgroups aged ≥65, Charlson comorbidity index (CCI) ≥2, gastric acid inhibitor use. Conclusions: In Chinese T2DM, treatment decreased admission, this responded positively metformin. suggest may have pleiotropic diabetes. Our has important clinical implications management other conditions increase

Language: Английский

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Insufficiency/deficiency of vitamin B12 in patients in the endocrinological practice

Diabetes Mellitus, Journal Year: 2024, Volume and Issue: 27(3), P. 314 - 320

Published: June 7, 2024

On March 20, 2024, an interdisciplinary meeting of the Expert Council on current problem B12 insufficiency/deficiency and prevalence this condition among endocrine patients was held at Endocrinology Research Centre (Moscow). The purpose to assess role deficiency in reducing quality life different groups outline a strategy for management with vitamin by endocrinologists. resolution expert council developed leading specialists various specialties.

Language: Английский

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