Metformin, marketed under the brand name Glucophage, is a cornerstone in the management of type 2 diabetes. This oral antidiabetic medication has been extensively studied and remains a first-line therapy due to its efficacy, safety profile, and cost-effectiveness.

Mechanism of Action

Metformin works primarily by decreasing hepatic glucose production and improving insulin sensitivity, which enhances peripheral glucose uptake and utilization. Unlike other antidiabetic drugs, metformin does not cause significant hypoglycemia when used as monotherapy, making it a safer option for many patients.

Clinical Applications

Metformin is recommended as the initial pharmacologic treatment for type 2 diabetes in conjunction with lifestyle modifications such as diet and exercise. It is particularly effective in overweight or obese patients due to its favorable effects on weight loss and cardiovascular risk factors.

Adverse Effects

The most common side effects of metformin are gastrointestinal, including diarrhea, nausea, and abdominal discomfort. These effects can often be mitigated by starting with a low dose and gradually increasing it. Rarely, metformin can cause lactic acidosis, a serious but uncommon condition.


Metformin continues to be a foundational treatment for type 2 diabetes, offering significant benefits in glucose control, weight management, and cardiovascular health. Its long-standing use and extensive research support its role as a first-line therapy in managing this chronic condition.

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