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The Unauthorized Biography

by Wil Dubois, BS, AAS, CPT, TPT

A month’s supply costs you about the same as a Starbucks latte. It’s one of the oldest drugs in active clinical use today, and it’s now the first-line drug for almost everyone with newly diagnosed Type 2 diabetes on the planet. Most of the millions of people who take it don’t give it a second thought, but humble metformin may well be the closest thing we have to a miracle drug.

Consider the following: Other than insulin, metformin packs probably the biggest blood-glucose-lowering punch of any diabetes drug on the market, lowering HbA1c levels (a measure of blood glucose control) by up to 1.5%. It protects your heart, and it might even hold some cancers at bay. It gets along well with a wide variety of other drugs and treatments, and by most measures, it’s safer than most other prescription drugs. Impressively, it’s risen from the ranks of a “me-too” drug (a drug that’s very similar to an existing drug) to the very pinnacle of diabetes treatment worldwide.

What do you know about this unsung hero among diabetes drugs? Check out this “biography” of metformin to learn everything you ever wanted to know, but were afraid — or didn’t even know — to ask.

The birth of metformin
When metformin was born to Dr. Jean Sterne at Aron Laboratories in Paris, France, in 1959, its proud father had no way to foresee how it would change the world. Initially (and still) sold under the trade name Glucophage, Greek for sugar eater, it would grow up to be a superstar, the most prescribed diabetes drug on the planet.

Like most drugs, metformin has its roots in a plant — in this case, the French lilac (Galega officinalis). Research into this plant’s potential as an antidiabetic agent dates back to the early 1920’s, but major efforts were abandoned with the discovery and development of insulin. It wasn’t until 30 years later, in the search for oral drugs to control diabetes, that these efforts resumed. While the French lilac has long been known to have glucose-lowering properties, it has also long been known to be poisonous. Because it is dangerous to livestock, here in the United States it’s listed as a noxious weed in 12 states, including pretty much every state it grows in.

And just how does metformin lower blood glucose? No one knows, despite the fact that it is one of the most studied compounds in the world, having been the subject of over 13,000 clinical researchers and more than 5,600 published studies over the last 60 years. The leading theories on metformin hold that it limits glucose production in the liver, or that it helps muscle tissue take in glucose. Or that it helps with carbohydrate absorption. Or that it’s a mild insulin sensitizer. It’s probably a combination of all of these factors, although this is far from a definite answer.

But metformin does work, and it works fast, nearly from the first pill. It also carries little risk of overdoing its job; when used alone as a treatment, metformin rarely causes hypoglycemia (low blood glucose). It does not cause weight gain, and in many people it causes mild weight loss. It reduces the risk of heart attack, can be combined with other blood-glucose-lowering drugs, and has few harmful side effects. (Click here to learn more about the side effects of metformin.) Yet in the beginning, metformin was nowhere near as beloved as it is today.

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