Metformin verkningsmekanism
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Metformin: update on mechanisms of action and repurposing potential
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Abstract
Metformin is the first-choice drug for treatment of type 2 diabetes notably those associated with obesity. It does not only reduce hyperglycemia, but also possesses pleiotropic effects opening the pave for numerous potential clinical applications. In this chapter we illustrate the various mechanisms of metformin action in reduction of hepatic glucose output, improvement of insulin action, restoration of fat metabolism and gut microbiome, reduction of inflammation, upregulation of antioxidant enzymes, and attenuation of tumor growth. Understanding of such mechanisms might propose further clinical applications for metformin.
Keywords
- 5′ AMP-activated protein kinase (AMPK)
- metformin
- gluconeogenesis
- antioxidant
- mammalian target of rapamycin (mTOR)
- complex 1
Samira Abdulla Mahmood*
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Aden University, Aden, Republic of Yemen
*Address all correspondence to: samabdulla@
1. Introduction
The mechanisms underlying metformin actions appear to be complex and responsible for the pleiotropic effects of metformin. These mechanisms remain a topic of considerable debate. Actually, in the la
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Diabetesläkemedel
Metformin medför mot skillnad ifrån insulin samt SU-preparat
Vad existerar metformin?
Metformin existerar en biguanid som besitter sitt ursprung i örtväxten getruta (Gallega offcinalis) likt använts inom olika läkemedelsberedningar sedan medeltiden. Idag utgör Metformin basen i modern behandling från diabetes typ 2.
Hur fungera Metformin?
- Hämmar glukoneogenes, d.v.s. nybildningen av sötningsmedel i levern
- Ökar det insulinberoende glukosupptaget inom perifer vävnad
- Minskar lipolysen samt därmed halten fria fettsyror som ombildas till glukos
- Påverkar tarmens mikrobiom vars effekter inte existerar fullständigt kartlagda
Ökad överlevnad tillsammans med Metformin?
Studien UKPDS 34 visade en mortalitetsreduktion om 34% för gruppen som behandlats med mg Metformin dagligen under 10 år jämfört med enbart diet. Tioårsuppföljning av UKPDS 34 visade en fortsatt riskreduktion inom mortalitet ifall 27% jämfört med placebo trots för att skillnaderna inom HbA1c snart utjämnats efter interventionens slut.