Background: Metformin is an oral hypoglycemic agent extensively used as first-line therapy
for type 2 diabetes. It improves hyperglycemia by suppressing hepatic glucose production and
increasing glucose uptake in muscles. Metformin improves insulin sensitivity and shows a beneficial
effect on weight control. Besides its metabolic positive effects, Metformin has direct effects on inflammation
and can have immunomodulatory and antineoplastic properties.
Aim: The aim of this narrative review was to summarize the up-to-date evidence from the current literature
about the metabolic and non-metabolic effects of Metformin.
Methods: We reviewed the current literature dealing with different effects and properties of Metformin
and current recommendations about the use of this drug. We identified keywords and MeSH terms in
Pubmed and the terms Metformin and type 2 diabetes, type 1 diabetes, pregnancy, heart failure, PCOS,
etc, were searched, selecting only significant original articles and review in English, in particular of the
last five years.
Conclusion: Even if many new effective hypoglycemic agents have been launched in the market in the
last few years, Metformin would always keep a place in the treatment of type 2 diabetes and its comorbidities
because of its multiple positive effects and low cost.