Metformin, the rebirth of a biguanide: mechanism of action and place in the prevention and treatment of insulin resistance

Metformin should be regarded as a first-choice therapy of type 2 diabetes, showing an especially good efficacy in obese patients with hyperinsulinaemi a. Reduction of blood glucose without hyperinsulinaemia and without hypogly caemia, favourable influence on the lipid profile and inhibition of coagula tion factors lead to an antidiabetic and antiatherogenic effect. Not only a re these characteristics relevant to judging the value of the drug, but als o the strict observation of contraindications is needed to avoid the danger ous complication of lactic acidosis.