Metformin

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Metformin is an oral prescription medication, classified as a biguanide, primarily used to manage type 2 diabetes mellitus. Approved by the FDA in 1994, it’s one of the most prescribed drugs globally, available as immediate-release (500–1,000 mg) or extended-release (500–2,000 mg) tablets under brands like Glucophage. It’s also explored for off-label uses like polycystic ovary syndrome (PCOS) and anti-aging.

 

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Mechanisms of Action
Metformin lowers blood glucose by reducing hepatic glucose production (gluconeogenesis), increasing insulin sensitivity in muscles, and decreasing intestinal glucose absorption. It activates AMP-activated protein kinase (AMPK), enhancing glucose uptake and inhibiting mTOR pathways, which may contribute to its anti-aging potential. It does not stimulate insulin secretion, minimizing hypoglycemia risk.

 

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Blood Sugar Control: Lowers HbA1c by 1–2% in type 2 diabetes patients.

 

Weight Management: Promotes modest weight loss (2–5 kg) by reducing appetite.

 

PCOS Treatment: Regulates menstrual cycles and ovulation in 50–70% of PCOS patients.

 

Cardiovascular Health: Reduces triglycerides and LDL cholesterol, lowering heart disease risk.

 

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Anti-Aging Potential: Animal studies suggest extended lifespan via reduced oxidative stress and inflammation.

 

Cancer Prevention: Observational studies link metformin to lower risks of certain cancers (e.g., breast, colon).

Dosage and Administration
Initial doses start at 500 mg once or twice daily with meals, titrated to 1,500–2,000 mg/day over weeks to minimize side effects. Maximum dose is 2,550 mg/day. Always follow medical guidance for dosing adjustments.

 

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Safety and Side Effects
Common side effects include nausea, diarrhea, and abdominal discomfort (20–30% of users), often subsiding with time. Rare but serious risks include lactic acidosis (1 in 30,000), particularly in renal impairment (eGFR <30 mL/min). . Not suitable for type 1 diabetes or ketoacidosis.