二甲双胍50年进程

The 50 years history of Metformin

二甲双胍可通过减少肝脏葡萄糖输出,提高胰岛素的敏感性,改善胰岛素抵抗等作用降低血糖。目前,美国糖尿病联合会和欧洲糖尿病研究学会达成共识,认为二甲双胍是治疗2型糖尿病的一线用药并贯穿治疗始终。除降低血糖外,二甲双胍在改善脂代谢,保护血管,以及治疗非酒精性脂肪肝和多囊卵巢综合征等疾病的运用中都发挥着独特的作用。最新的研究发现,二甲双胍对促甲状腺激素也有一定影响。二甲双胍最常见的不良反应为胃肠道反应,乳酸酸中毒则非常罕见,故能安全地用于糖尿病前期与糖尿病的治疗。许多大型临床研究如英国前瞻性糖尿病研究均已证实二甲双胍治疗可对心血管疾病的预后产生有益影响。

Mefformin can increase the sensitivity of insulin and ameliorate the insulin resistance through decreasing the output of hepatic glycogen. American Diabetes Association and European Association for the Study of Diabetes have reached the consensus that Metformin is the first-line drug in the treatment of diabetes and should be applied during the whole course. Meanwhile, its distinct effects, such as improving lipid metabolism, protecting the blood vessels, treatment of non-alcoholic fatty liver disease （ NAFLD ） and polyeystic ovary syndrome （PCOS） have been elucidated. Increasing evidences have indicated that Metformin can reduce the level of thyrotropie stimulating hormone（TSH）. Gastrointestinal side effects of Metformin are common, but the lactic acidosis is scarce. Metformin can be used in patients with pre-diabetes or diabetes safely. Many clinical trials such as the UK prospective diabetes study have shown that Metformin is benefit for the patients with cardiovascular disease.