Metformin-Humble beginnings, exciting future?
These days metformin is the first line medication recommended for the treatment of prediabetes and Type 2 diabetes. It has a very interesting history. It is derived from a plant, Galega officinalis, commonly known as goat’s rue or French lilac. Goat’s rue was used as far back as the 17th century in medieval Europe to treat dysuria, among other problems. Extracts from the plant were used in 1920’s and 30’s to treat diabetes in France. It contains at least 2 powerful alkaloids, guanidine and galegine. The former proved too toxic and research into galegine led in 1929 to the synthesis of several biguanides, including dimethylbiguanide (metformin).
Jean Sterne, a physician and clinical pharmacologist, studied biguanides and in 1957 published findings on dimethylbiguanide; he also coined the name Glucophage (glucose eater). Metformin was first used clinically in 1958 in the UK. It was not approved for use in the USA until 1995, possibly due to occurrences of lactic acidosis from a different biguanide, phenformin, whose use was discontinued in most countries by the late 1970’s.
Metformin’s mode of action is still not fully understood; it reduces the rate of gluconeogenesis, increases peripheral glucose disposal and possesses antioxidant activity. Research continues to assess metformin’s anti-cancer, anti-cardiovascular disease and renal protective effects.
Perhaps the most exciting research is into the possibility that metformin may be the world’s first anti-aging pill. While this is in the beginning stages of testing I find it interesting to consider that the medication being tested is not that far removed from an herbal remedy used 400 years ago.