Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 May 21;321(19):1926-1927.
doi: 10.1001/jama.2019.3805.

Metformin in 2019

James Flory  1 , Kasia Lipska  2
Affiliations
Review

Metformin in 2019

James Flory et al. JAMA. .

Abstract

Metformin is the first-line pharmacologic treatment for type 2 diabetes and the most commonly prescribed drug for this condition worldwide, either alone or in combination with insulin or other glucose-lowering therapies. Metformin is a biguanide, a drug class of herbal origin that has been widely used to treat diabetes since the 1950s., Two other biguanides were withdrawn from clinical use because they caused lactic acidosis. Metformin was also taken off the US market due to concerns over lactic acidosis, but it subsequently has been proven safe and effective in lowering glucose levels and was reintroduced in 1995. Optimal metformin use requires clear understanding of its effects, dosing, safety, and alternatives.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Flory reported receiving grants from AHRQ, a contract from PCORI, and personal fees from Eli Lilly and Genentech outside the submitted work. Dr Lipska reported receiving grants from NIA, support to develop and evaluate publicly reported quality measures from CMS, and personal fees from Health Services Advisory Group outside the submitted work.

Figures

Figure.
Figure.. Suggested Starting Regimen for Metformin, Common Obstacles to Use, and Alternatives
Characterization of alternative medications is based on current American Diabetes Association guidelines for pharmacologic treatment of type 2 diabetes. eGFR indicates estimated glomerular filtration rate.
See this image and copyright information in PMC

Comment in

  • Metformin for Type 2 Diabetes.
    Caturano A, Galiero R, Pafundi PC. Caturano A, et al. JAMA. 2019 Oct 1;322(13):1312. doi: 10.1001/jama.2019.11489. JAMA. 2019. PMID: 31573630 No abstract available.
  • Metformin for Type 2 Diabetes.
    Patel JJ, Mundi MS. Patel JJ, et al. JAMA. 2019 Oct 1;322(13):1312-1313. doi: 10.1001/jama.2019.11497. JAMA. 2019. PMID: 31573632 No abstract available.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rena G, Hardie DG, Pearson ER. The mechanisms of action of metformin. Diabetologia. 2017;60(9): 1577–1585. - PMC - PubMed
    1. Inzucchi SE. Is it time to change the type 2 diabetes treatment paradigm? no! Diabetes Care. 2017;40(8):1128–1132. - PubMed
    1. FDA. Label information: glucophage tablets and glucophage XR extended-release tablets. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020357s037s039.... Accessed April 16, 2019.
    1. American Diabetes Association. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42(suppl 1):S90–S102. - PubMed
    1. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998; 352(9131):854–865. - PubMed

MeSH terms