Metformin: mechanistic and cardiovascular effects
Abstract
Metformin is a drug that has been used for the treatment of diabetes for 65 years. Research shows that metformin is a versatile drug that not only has beneficial effects on lowering blood sugar levels, but also has protective effects on cardiovascular disease and aging processes. This thesis describes a number of studies from Dutch research (the HOME study) conducted among 390 patients with type 2 diabetes which were, in addition to insulin, either treated with metformin or with a placebo drug. The studies showed that metformin has a potentiating effect on the production of the body's own insulin in the pancreas. Also, the absorption of vitamin D was not disturbed by the use of metformin. In addition, the effect of metformin on the cardiovascular system was studied. Metformin had no effect on the hormone BNP and the protein troponin, important signaling substances for damage to the heart muscle. As for the vessel wall there was no effect on two harmful waste products (ADMA and SDMA), but there was a decrease in the substance arginine. The significance of this finding can be both favorable and unfavorable for the vessel wall. Finally, a literature review is provided describing the effect of metformin on the prevention of cardiovascular disease, dementia and cancer. It is clear that there is mounting evidence that metformin has a beneficial effect in all these areas, possibly also having added value for the large group of people without diabetes.
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