Metformin decreasing hepatic glucose production

Metformin improves glucose tolerance in NIDDM subjects by lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity (increases peripheral glucose uptake and utilization). 

Metformin restrains hepatic glucose production principally by suppression of gluconeogenesis. The mechanisms involve potentiation of insulin action and decreased hepatic extraction of certain gluconeogenic substrates such as lactate. In addition, metformin reduces the rate of hepatic glycogenolysis and decreases the activity of hepatic glucose-6-phosphatase. Insulin-stimulated glucose uptake and glycogenesis by skeletal muscle is increased by metformin mainly by increased... 

Biguanides Metformin (Glucophage) Act directly on the liver to decrease hepatic glucose production also increase sensitivity of peripheral tissues (muscle) to insulin Gastrointestinal disturbances lactic acidosis may also occur in rare cases, and this effect can be severe or fatal... 

Metformin hydrochloride is a biguanide that decreases blood glucose by decreasing hepatic glucose production. It may also decrease intestinal absorption of glucose and increase response to insulin. Metformin is indicated as an adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes mellitus. Metformin IR tablets and oral solution are indicated in patients 10 years of age and older. The ER tablets are indicated in patients 17 years of age and older. In combination with a sulfonylurea or insulin to improve glycemic control, metformin is indicated in patients 17 years of age and older. 

Antidiabetic Drugs other than Insulin. Figure 3 The antihyperglycaemic effect of metformin involves enhanced insulin-mediated suppression of hepatic glucose production and muscle glucose uptake. Metformin also exerts non-insulin-dependent effects on these tissues, including reduced fatty acid oxidation and increased anaerobic glucose metabolism by the intestine. FA, fatty acid f, increase i decrease. 

Metformin Obscure Reduced hepatic and renal gluconeogenesis Decreased endogenous glucose production Type 2 diabetes Oral maximal plasma concentration in 2-3 h Toxicity Gastrointestinal symptoms, lactic acidosis (rare) cannot use if impaired renal/hepatic function congestive heart failure (CHF), hypoxic/acidotic states, alcoholism... 

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