Metformin Expert Consensus 2023: Clinical Use
Metformin remains the first-line medicine for type 2 diabetes, working on liver, muscle, and gut with benefits beyond glucose and a favorable safety profile.
Why Metformin Is First Line
Metformin is the preferred first medicine for type 2 diabetes. It is used unless there is a clear reason not to. It can be taken for the whole course of treatment.
How It Works
It lowers sugar made by the liver and improves insulin use in tissues. It also acts on the gut to modestly reduce glucose absorption. The result is lower fasting and meal-related glucose.
Dose And Use
Treatment starts low with meals to reduce stomach upset. The dose is slowly increased to an effective level. Extended-release forms are often easier to tolerate.
Benefits Beyond Sugar
Metformin may protect the heart and lower weight slightly. It is useful in people with obesity or fatty liver. It can also help women with polycystic ovary syndrome.
Special Groups
Older adults need careful kidney checks and gentle targets. It may be used in children aged ten and above. In pregnancy insulin remains the preferred choice.
Safety
It rarely causes low blood sugar on its own. The main side effects are digestive and usually fade. Kidney function should be reviewed before and during use.
