European Journal of Biomedical and Pharmaceutical Sciences

METFORMIN AND ITS UNIQUE MOLECULAR PHARMACOLOGY IN REGULATING TYPE 2 DIABETES

Rashidul Haque* and Sultana Rajia

ABSTRACT

Metformin is the most commonly prescribed drug to treat type 2 diabetes mellitus because of its outstanding ability to decrease plasma glucose levels. It is a synthetic biguanide, orally effective and insulin sensitizing drug that exerts its action through the inhibition of mitochondrial electron transport chain (complex I) and glycerol-3-phosphate dehydrogenase (GPD2), resulting in the increased AMP/ATP ratio and increased AMP-kinase activity in the cytosol. AMPK turns out to be the key target enzyme of metformin to reduce plasma glucose levels. Over time, metformin has been found beneficial not only to treat diabetes, but it has shown benefits to treat various other diseases as well, such as polycystic ovary syndrome (PCOS), cancers, obesity, liver diseases, cardiovascular disease, renal diseases, and even aging. This paper will critically review the possible underlying mechanisms of metformin's miraculous strategies (in lowering plasma glucose level) at the molecular level, which will also provide an updated reference for the clinicians and researchers.

Keywords: Metformin, AMP-kinase, Diabetes, Gluconeogenesis, Glucose transporters, Insulin resistance.