Treatment with metformin

Clifford J. Bailey*

*Corresponding author for this work

Research output: Chapter in Book/Published conference outputChapter (peer-reviewed)peer-review


Metformin is an anti-hyperglycaemic agent widely used in the treatment of type 2 diabetes. It counters insulin resistance through insulin-dependent and -independent effects on cellular nutrient and energy metabolism, improving glycaemic control without weight gain and without increasing the risk of hypoglycaemia. Metformin can also benefit several risk factors for vascular disease independently of glycaemic control. In subjects with metabolic syndrome, metformin improves prognosis. It decreases progression of impaired glucose tolerance to type 2 diabetes, assists weight reduction especially in conjunction with lifestyle management and exerts other potentially favourable cardiovascular effects. For example, metformin can modestly improve the lipid profile in some dyslipidaemic individuals, reduce pro-inflammatory cytokines and monocyte adhesion molecules and decrease advanced glycation end products. Metformin can also improve parameters of endothelial function in the macro- and micro-vasculature, indicating lower athero-thrombotic risk, but it does not appear to reduce blood pressure. In normoglycaemic individuals with risk factors for diabetes and in women with polycystic ovary syndrome there is evidence that metformin can defer or prevent the development of diabetes. Thus, metformin offers beneficial effects to delay the onset and reverse or reduce the progression of many of the metabolic features and cardiovascular risk factors associated with metabolic syndrome.
Original languageEnglish
Title of host publicationThe metabolic syndrome
Subtitle of host publicationpharmacology and clinical aspects
EditorsHenning Beck-Nielsen
Place of PublicationVienna (AT)
Number of pages18
ISBN (Electronic)978-3-7091-1331-8
ISBN (Print)978-3-7091-1330-1
Publication statusPublished - 1 Mar 2013


  • metformin
  • metabolic


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