Metformin: Nature’s Gift that Keeps on Giving More

Abstract

Despite many different drugs being available for type 2 diabetes, metformin remains a cornerstone in the management of diabetes. In a consensus statement, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recommend metformin as the first step in the treatment type 2 diabetes, in the absence of drug contraindications.[1] Thus, worldwide, metformin is now the unanimous first‑line glucose‑lowering agent. While several recent antidiabetic drugs have been under the cloud, some being withdrawn, others asked to give warnings in labels and a few still under strict Food and Drug Administration (FDA) scrutiny, metformin, a time‑tested drug, has surpassed the hurdles and become the most prescribed medicine in diabetes and other conditions of insulin resistance. Why is there now a “metformin wave” everywhere? Here, we will discuss this “metformin paradox” of an old wine in a new bottle.