Metformin in the Management of Type 2 Diabetes Mellitus: Past, Present, and Future

Metformin has been the cornerstone of type 2 diabetes mellitus (T2DM) management for over six decades. This biguanide medication has demonstrated remarkable efficacy, safety, and cost-effectiveness, maintaining its position as the first-line pharmacological therapy for T2DM worldwide. This comprehensive review examines the historical development of metformin, its mechanisms of action, current clinical applications, safety profile, and emerging therapeutic possibilities. We explore metformin's journey from botanical origins to modern medicine, its pleiotropic effects beyond glycemic control, and potential future applications in various disease states. Understanding metformin's multifaceted pharmacology provides insights into optimizing diabetes care and developing novel therapeutic strategies

• Publication year

  2025

• Venue

  International Journal of Advanced Research in Science, Communication and Technology

• Publication date

  2025-11-10

• Fields of study

  Not labeled

• Identifiers
  DOI 10.48175/ijarsct-29726
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

• The selection and use of essential medicines, 2025

  2025cited by this paper
• Addendum. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023. Diabetes Care 2023;46(Suppl. 1):S19-S40.

  2023cited by this paper
• Addendum. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2020. Diabetes Care 2020;43(Suppl. 1):S98–S110

  2020cited by this paper
• Type 2 diabetes and cardiovascular prevention: the dogmas disputed

  2018cited by this paper
• Metformin Treatment in Patients With Type 2 Diabetes and Chronic Kidney Disease Stages 3A, 3B, or 4

  2018cited by this paper
• Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

  2018cited by this paper
• Metformin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug

  2017cited by this paper
• Metformin reduces all-cause mortality and diseases of ageing independent of its effect on diabetes control: A systematic review and meta-analysis.

  2017cited by this paper
• Clinical Outcomes of Metformin Use in Populations With Chronic Kidney Disease, Congestive Heart Failure, or Chronic Liver Disease

  2017cited by this paper
• Metformin: historical overview

  2017cited by this paper
• New IDF clinical practice recommendations for managing type 2 diabetes in primary care.

  2017cited by this paper
• Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis

  2016cited by this paper
• Metformin and the gastrointestinal tract

  2016cited by this paper
• Comparison of Clinical Outcomes and Adverse Events Associated With Glucose-Lowering Drugs in Patients With Type 2 Diabetes: A Meta-analysis.

  2016cited by this paper
• Metformin as a Tool to Target Aging.

  2016cited by this paper
• The Primary Glucose-Lowering Effect of Metformin Resides in the Gut, Not the Circulation: Results From Short-term Pharmacokinetic and 12-Week Dose-Ranging Studies

  2015cited by this paper
• Emerging wastewater contaminant metformin causes intersex and reduced fecundity in fish.

  2015cited by this paper
• Long-term Effects of Lifestyle Intervention or Metformin on Diabetes Development and Microvascular Complications: the DPP Outcomes Study

  2015cited by this paper
• Metformin and Cancer Risk and Mortality: A Systematic Review and Meta-analysis Taking into Account Biases and Confounders

  2014cited by this paper
• Metformin in patients with type 2 diabetes and kidney disease: a systematic review.

  2014cited by this paper
• Metformin: from mechanisms of action to therapies.

  2014cited by this paper
• Can people with type 2 diabetes live longer than those without? A comparison of mortality in people initiated with metformin or sulphonylurea monotherapy and matched, non‐diabetic controls

  2014cited by this paper
• Management of hyperglycemia in type 2 diabetes: a patient-centered approach. Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012;35:1364–1379

  2013cited by this paper
• Metformin in non-alcoholic fatty liver disease: A systematic review and meta-analysis.

  2013cited by this paper
• Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline

  2013cited by this paper
• Opposite effects of statins on mitochondria of cardiac and skeletal muscles: a 'mitohormesis' mechanism involving reactive oxygen species and PGC-1.

  2012cited by this paper
• Comparative Effectiveness of Sulfonylurea and Metformin Monotherapy on Cardiovascular Events in Type 2 Diabetes Mellitus

  2012cited by this paper
• Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials

  2012cited by this paper
• NHS Diabetes guideline for the perioperative management of the adult patient with diabetes *

  2012cited by this paper
• Occurrence and fate of the antidiabetic drug metformin and its metabolite guanylurea in the environment and during drinking water treatment.

  2012cited by this paper
• A clinical trial to maintain glycemic control in youth with type 2 diabetes.

  2012cited by this paper
• Use of Metformin in the Setting of Mild-to-Moderate Renal Insufficiency

  2011cited by this paper
• Clinical Pharmacokinetics of Metformin

  2011cited by this paper
• Metformin and digestive disorders.

  2011cited by this paper
• Comparative Effectiveness and Safety of Medications for Type 2 Diabetes: An Update Including New Drugs and 2-Drug Combinations

  2011cited by this paper
• Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial

  2010cited by this paper
• The Effect of Oral Antidiabetic Agents on A1C Levels

  2010cited by this paper
• Long-term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus.

  2009cited by this paper
• Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

  2009cited by this paper
• Reduced-Function SLC22A1 Polymorphisms Encoding Organic Cation Transporter 1 and Glycemic Response to Metformin: A GoDARTS Study

  2009cited by this paper
• Metformin versus insulin for the treatment of gestational diabetes.

  2008cited by this paper
• 10-year follow-up of intensive glucose control in type 2 diabetes.

  2008cited by this paper
• Metformin: its botanical background

  2004cited by this paper
• Gastrointestinal tolerability of extended-release metformin tablets compared to immediate-release metformin tablets: results of a retrospective cohort study

  2004cited by this paper
• A Systematic Review of Adherence With Medications for Diabetes

  2004cited by this paper
• Metformin as an adjunct therapy in adolescents with type 1 diabetes and insulin resistance: a randomized controlled trial.

  2003cited by this paper
• The blooming of the French lilac.

  2001cited by this paper
• Mechanism by which metformin reduces glucose production in type 2 diabetes.

  2000cited by this paper
• Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34)

  1998cited by this paper
• Clinical Pharmacokinetics of Metformin

  1996cited by this paper
• Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group.

  1995cited by this paper
• Metformin kinetics in healthy subjects and in patients with diabetes mellitus.

  1981cited by this paper
• Lactic acidosis in biguanide-treated diabetics

  1978cited by this paper

• No citing papers are available for this paper.