| The main use for metformin is in the treatment of diabetes mellitus type 2,
especially when this accompanies obesity and insulin resistance. Metformin
is the only anti-diabetic drug that has been proven to reduce the cardiovascular
complications of diabetes, as shown in a large study of overweight patients
with diabetes. Unlike the other most-commonly prescribed class of oral
diabetes drugs, the sulfonylureas, metformin (taken alone) does not induce
hypoglycemia. Hypoglycemia during intense exercise has been documented,
but is extremely rare. It also does not cause weight gain, and may indeed
produce minor weight loss. Metformin also modestly reduces LDL and triglyceride
levels.
It is also being used increasingly in polycystic ovarian syndrome (PCOS),
non-alcoholic fatty liver disease (NAFLD) and premature puberty, three
other diseases that feature insulin resistance; these indications are still
considered experimental. Although metformin is not licenced for use in PCOS,
the United Kingdom's National Institute for Health and Clinical Excellence
recommends that women with PCOS and a body mass index above 25 be given metformin
when other therapy has failed to produce results. The benefit of metformin
in NAFLD has not been extensively studied and may be only temporary. |