Title:Efficacy and Cardiovascular Safety of Metformin
Volume: 16
Issue: 2
Author(s): Ranjith K. Rajgopal and Rupinder S. Kochhar*
Affiliation:
- Department of Diabetes & Endocrinology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston,United Kingdom
Keywords:
Metformin, cardiovascular safety, type 2 diabetes mellitus, polycystic ovarian syndrome (PCOS), glycated hemoglobin
(HbA1c), cancer.
Abstract: Metformin has been the cornerstone of the medical management of type 2 diabetes mellitus
(T2DM) for over 6 decades now since its first-ever discovery. Although there were initial concerns
about its efficacy and safety, increasing evidence over the years proved it to be very effective
and safe. It has stood the test of time, proving to be much safer than other drugs in the same class
and garnering robust evidence in cardiovascular safety. In patients with T2DM, metformin lowers
mean glycated hemoglobin (HbA1c) levels by 1.1–1.2% as monotherapy, by 0.6–0.83% as an add-
on therapy to insulin, and by 0.9- 0.95% as add-on therapy to other oral agents. Recently its use
has also been explored for unlicensed indications other than diabetes, including but not limited to
obesity, polycystic ovarian syndrome (PCOS), and type 1 diabetes. Metformin is also currently under
investigation for its role as a cancer adjuvant therapy. We aim to provide a comprehensive review
of the available evidence for the safety and efficacy of metformin.
