New findings on metformin.👀👀👀

Every once in a while, new benefits of metformin are discovered. Earlier this
year, a large cohort study conducted by researchers from the University of Southern Denmark in Denmark and Stanford University in the United States also found new findings on metformin. The study noted that men took metformin in the three months before conception (during sperm development). His male offspring will be more prone to reproductive organ defects at birth. The incidence of severe defects of the genitals or urinary tract was 3.39 times that of the control group. They also found that a man taking metformin for a year before or after the 90 days window period for sperm production did not affect his male offspring. However, it is worth noting that the findings of this study are only preliminary and observational and require further confirmation. Men who are taking metformin do not need to stop taking metformin before trying to conceive. In fact, many reasons for miscarriage are due to problems with men's sperm. It takes about 90 days for sperm to develop, form and finally mature in the epididymis. Therefore, men should also prepare for pregnancy three months in advance to improve the quantity and quality of sperm.

Mechanism of action of metformin.

Metformin reduces postprandial blood glucose levels by delaying intestinal absorption of glucose, increasing GLP-1 levels, reducing peripheral insulin resistance, and increasing muscle tissue uptake and utilization of glucose. It also reduces fasting blood glucose levels by reducing hepatic insulin resistance and reducing hepatic glucose output. The reduction in postprandial blood glucose and fasting blood glucose results in a reduction in HbA1c.

Common adverse reactions of metformin.

Common adverse reactions to metformin are headache, nausea, vomiting, bloating, indigestion, abdominal discomfort, diarrhea and fatigue. Most patients experience adverse reactions within the first 10 weeks of treatment. These adverse reactions generally will be gradually tolerated or disappear with the extension of treatment time. 

Therapeutic dose of metformin.

The minimum recommended dose of metformin is 500 mg per day and the optimal effective dose is 2000 mg per day. The maximum dose for adults in ordinary tablets is 2550 mg per day and the maximum recommended dose in extended-release formulations is 2000 mg per day. Switching to metformin sustained-release preparations, starting with small doses and gradually increasing the dose are all effective ways to reduce the occurrence of adverse reactions. In addition, long-term use of metformin may affect the absorption of vitamin B12, resulting in a decrease in vitamin B12 levels in the patient's body.

Other effects of metformin.

Cardiovascular protection.

Insulin resistance in diabetic and non-diabetic patients is improved by metformin. This reduces basal and post-load insulin levels, which directly and indirectly protects the cardiovascular system.

Improve blood lipid levels.

Fat synthesis and metabolism are improved by metformin. Studies have shown that metformin can significantly reduce triglyceride, LDL-cholesterol and total cholesterol levels in patients with type 2 diabetes, but it did not significantly alter the effect of HDL-cholesterol.

Improve the effect of non-alcoholic fatty liver.

Generally, patients with nonalcoholic fatty liver disease can safely take metformin. Unless the patient has significant hepatic impairment (such as serum transaminases greater than three times the upper limit of normal), hepatic insufficiency, or decompensated cirrhosis.

Treatment of polycystic ovary syndrome.

Polycystic ovary syndrome is a heterogeneous disorder characterized by polycystic ovary morphology, ovarian dysfunction, and hyperandrogenism. Its pathogenesis is unclear. Patients usually have varying degrees of hyperinsulinemia. There is medical evidence that metformin reduces androgen levels, plasma insulin levels and increases estradiol levels. It can improve menstrual regularity, improve hirsutism and induce ovulation in polycystic ovary syndrome patients.

Antitumor effect.

Diabetes may be a risk factor for a variety of tumors, including breast, pancreatic, colorectal, and endometrial cancers. Several studies have shown that metformin inhibits tumor initiation and progression. It reduces the risk of breast, lung, rectal, prostate and other cancers.

Other potential effects of metformin.

Alter gut flora.

A study found that the gut microbiome of patients with type 2 diabetes was favorably changed by metformin.

Reduce the risk of Parkinson's disease in patients with type 2 diabetes.

Metformin promotes the growth of new neurons and repairs damage to the nervous system.

Reversal of left ventricular hypertrophy in non-diabetic patients.

Studies have shown that metformin can improve vascular endothelial cell function, delay myocardial cell apoptosis, inhibit ventricular remodeling, and reduce patient weight. These effects may reverse left ventricular hypertrophy in non-diabetic patients.

Prevent age-related macular degeneration.

A study found that people with type 2 diabetes who took metformin had a significantly lower incidence of age-related macular degeneration. This may be related to the antioxidant and anti-inflammatory functions of metformin.

Reversal of pulmonary fibrosis.

Studies have shown that the use of metformin can re-sensitize myofibroblasts to apoptosis. And in mouse models, metformin can speed up the ablation of already fibrotic tissue.

Promote hair growth.

Studies have found that metformin can stimulate telogen hair follicles to enter the growth phase and promote hair growth in mice.

Reduce the risk of blood clots caused by haze.

There are animal studies showing that inflammation caused by smog is prevented by metformin. It inhibits the formation of arterial blood clots, thereby reducing the risk of cardiovascular disease.

Reduce adverse effects of glucocorticoid therapy.

Some studies have shown that patients treated with glucocorticoids and metformin have the possibility of reversing the adverse effects of glucocorticoids.

Finally, metformin can cause fatal lactic acidosis. Therefore, metformin should be used under the guidance of a doctor or pharmacist. Although new effects of metformin are frequently discovered recently, few of them are certified by medical guidelines.