Metformin is only suitable for fat sugar friends? Heard that you can lose weight?

As an oral hypoglycemic drug that has entered thousands of households, metformin has been used clinically for more than 60 years since its introduction in 1957

With the continuous in-depth study of metformin in recent years, it has been found that in addition to reducing sugar, metformin also performs well in other aspects, such as weight loss [1].

At the same time, some diabetics have different worries: weight loss can be stopped at any time, and antidiabetic drugs can not be stopped! Can metformin really be used to lose weight? Will long-term eating keep slimming down?

Numerous studies have shown that for overweight and obese type 2 sugar friends, metformin does have two brushes for weight loss, but it cannot be used for weight loss

This has to start with the mechanism of action of metformin

Weight loss is an added bonus for sugar friends after improving metabolism

For patients with type 2 diabetes mellitus, the hypoglycemic effect of metformin is clear -

Improve insulin sensitivity and glucose uptake and utilization in peripheral tissues [3,6]

Inhibits hepatic glycogens and decomposition, reduces hepatic sugar output [2,6]

Inhibits intestinal absorption of glucose and increases the level of GLP-1 (glucagon-like peptide-1) [4-6]

In general, metformin reduces the source of blood sugar and increases the way of blood sugar, thereby achieving the purpose of

At present, a number of clinical trials have proved that metformin can safely and effectively improve insulin resistance, and has a certain weight control effect

The Diabetes Prevention Program (DPP) study in the United States selected 3234 obese patients with prediabetes were randomly assigned to the lifestyle intervention group, placebo group and metformin group

So, for the masses who clamor all day to lose weight, but do not have diabetes and no insulin resistance, can they use metformin to lose weight?

The answer is no

The "weight loss" of metformin is an additional benefit for overweight, obese diabetic patients to return to normal weight after improving glucose metabolism, which can be said to be an "unexpected gain"

Ordinary people want to lose weight, or the old saying: keep your mouth shut and open your legs

Metformin, overweight, obese sugar friends are suitable for eating?

Seeing this, some people may ask: Since metformin can lose weight, is it only suitable for overweight and obese sugar friends? Will sugar friends of normal weight eat more and get thinner? Doesn't it say that there are gastrointestinal adverse reactions?

In fact, the hypoglycemic reduction of metformin is full of

Both retrospective and prospective clinical studies [8-10] showed that metformin was equally

There are also research data showing that metformin has a significant effect on weight reduction in obese groups and hypercombinant type 2 diabetic patients, and has less effect on the weight of normal-weight patients [11].

That is to say, metformin has a wide range of applications, as long as there are no contraindications and intolerances, sugar friends with normal weight can also obtain good hypoglycemic benefits

In addition, a considerable number of type 2 diabetic patients with normal weight in China have met the diagnostic criteria for abdominal obesity [waist circumference≥ 90 cm (male) or ≥85 cm (female)].

Increased visceral fat may be the main cause of insulin resistance in obese patients [13], which is one of the core pathophysiology mechanisms of type 2 diabetes

Metformin activates AMPK (adenylate-activating protein kinase), improves energy metabolism in muscle, fat, and liver [10], and reduces visceral fat
.
This is undoubtedly good for some sugar friends who "steal fat"
.

The safety and efficacy of metformin have been tested for a long time

Sugar friends may have some adverse reactions when taking metformin, mainly gastrointestinal reactions
.
However, this gastrointestinal response is mostly transient, and most patients gradually tolerate or disappear symptoms as treatment is prolonged [1
].

According to the recommendations of the Expert Consensus on the Clinical Application of Metformin (2018 Edition), metformin is generally taken in small doses, and gradually increases the dose when tolerated, helping to reduce gastrointestinal adverse reactions
.

In addition, sugar friends can also choose a relatively small dosage form of gastrointestinal stimulation, such as metformin proto-drug sustained-release tablets belong to this, after taking the drug, the drug is slowly released, reducing gastrointestinal adverse reactions, and eating a tube for a day, greatly reducing the probability
of missing and forgetting to take.

Metformin is the original research drug, that is, metformin patent drug, is an original hypoglycemic drug approved for marketing through strict clinical trials, with the advantages of the preparation process and strict supervision before and after marketing, so it has a more stable absorption rate and fewer adverse reactions
.

All in all, metformin, as the first-line drug of choice for type 2 diabetes, has been prepared into a compound by Irish chemists Werner and Bell in 1922 for a hundred years, and its clinical application has been more than 60 years, and its safety and efficacy have been tested
for a long time.

The Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition) states that if there are no contraindications, metformin should always remain in the drug regimen for diabetes mellitus (Class A recommended).

Editor: Zhou Ruiyun

Drawing: Liao Qin

Produced by: China Family Doctor Magazine

Academic Guidance Guo Ying Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Ph.
D.
, Chief Physician, Master Supervisor

●Member of the pituitary group of the Endocrinology Branch of the Chinese Medical Association

●Youth Member of The Department of Endocrinology and Metabolism branch of the Chinese Medical Doctor Association

●Deputy Leader of the Youth Group of the Endocrinology Physician Branch of Guangdong Medical Doctor Association

●Standing committee member of the Atherosclerotic Disease Professional Committee of Guangdong Geriatric Health Care Association

●Director of the Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shenzhen Shantou Central Hospital

●Deputy Director of Pituitary-Adrenal Subspecialty, Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University

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