Abstract
Metformin is an oral antidiabetic used in the treatment of type 2 diabetes mellitus. More precisely, it belongs to the class of biguanides, Metformin is used in the treatment of type 2 diabetes mellitus both as monotherapy and in combination therapy with other oral antidiabetic agents or with insulin, when dietary interventions and exercise are not sufficient to control the disease. When used in overweight diabetic patients, metformin also causes a decrease in the complications of diabetes and its use has been associated with stabilization and, albeit modest, loss of body weight.In type 2 diabetes mellitus (called also DM2 and in the past 'adult diabetes' or 'food') the insulin produced by the pancreas is unable to fully exert its action so that the body even produces it in excess, with the result on the one hand of making increasing weight and on the other hand progressively depleting the pancreas, is unable to meet the body's needs. It is as if the body were resisting the action of insulin. Metformin reduces insulin resistance. It is taken by mouth and is the only drug useful in all stages of type 2 diabetes. It also helps improve the balance of fats and, to a limited extent, blood pressure. Metformin alone has important effects on blood sugar. Accompanied by physical exercise, weight loss and possibly other medications, it is often an effective therapy. It does not cause hypoglycemia, helps not to gain weight or even reduces it. The main feature of Metformin is to interact strongly with AMPK by regulating its expression. In fact, its down regulation leads to consuming ATP, synthesizing cholesterol and fatty acids and consuming glucose: a situation in which insulin levels are quite high (therefore energy abundance).On the contrary, its up regulation leads to the creation of ATP, consuming more fatty acids for energy purposes and it is a metabolic situation similar to caloric restriction in which insulin levels are kept low (therefore energy scarcity). Metformin by upregulating AMPK has therefore shown to have a somewhat transversal therapeutic use in the treatment of metabolic dysfunctions.