Newest Research on Metformin and Type 2 Diabetes
The oral antidiabetes drug metformin is probably the most recognized drug for treatment of diabetes in the world except for insulin, and it also is widely prescribed. If you take drugs for type 2 diabetes, chances are metformin is one of them.
Although metformin has been around for decades (since 1972 in Canada and 1995 in the US), research continues on its use in diabetes as well as for other conditions that involve insulin resistance. If you use this drug, it’s a good idea to keep up with the latest research about what else metformin can do besides assist in the management of diabetes.
Metformin and your liver
Many individuals who have type 2 diabetes also struggle with obesity, and scientists are always searching for information on how and why certain drugs may or may not help this population of patients. Metformin happens to be a drug that seems to be beneficial, and now a team at McMaster University has figured out why.
Using a special mouse model, the researchers found that metformin reduces fat molecules in the liver, and this action in turn allows the hormone insulin to do a better job of taking sugar from the blood. This discovery is important for several reasons.
For example, this better understanding will assist researchers in developing therapies for individuals who do not respond to metformin. Another reason is that since metformin targets fat molecules rather than glucose metabolism, it may be helpful in patients who have type 2 diabetes and fatty liver, a condition that frequently occurs in obese diabetics.
New metformin combo drug
Metformin is popular as the co-ingredient in several drugs for type 2 diabetes, and a new one is now in the pipeline and on course for approval by the European Medicines Agency’s Committee for Medicinal Products for Human Use. The new drug is called Xigduo, and it represents the first time metformin (which is in the drug class biguanide) has been combined with a sodium-glucose cotransporter-2 (SGLT2) inhibitor, dapagliflozin (Forxiga).
Xigduo is a product of AstraZeneca/Bristol-Myers Squibb, as is Forxiga. The new drug combination is indicated for use, along with diet and exercise, in adults with type 2 diabetes who have not achieved adequate glycemic control from their current metformin treatment.
The new drug also can be used along with insulin or other drugs that lower glucose levels in patients who have not responded well to metformin and these other medications, as well as for individuals who are now taking metformin and dapagliflozin as separate drugs.
At this time, dapagliflozin is available in 28 European Union member states as well as in seven other countries, not including the United States. The drug was rejected by the Food and Drug Administration in January 2012 after previously being voted down because of potential cancer risks.
US residents may soon see another metformin-combo drug on the market, however. A second SGLT-2 inhibitor called canagliflozin (Invokana Janssen Pharmaceuticals) has FDA (but not EU) approval and will be paired with metformin in the near future for US use.
One certain thing about the pharmaceutical industry is change, and so it’s wise to keep abreast of the latest innovations in type 2 diabetes medications and their risks and benefits. The same advice applies to ways to avoid medication use and to manage the disease as naturally as possible.
Fullerton MD et al. Single phosphorylation sites in Acc1 and Acc2 regulate lipid homeostasis and the insulin-sensitizing effects of metformin. Natural Medicine 2013 Nov 3. Epub ahead of print