60 years of metformin use: a glance at the past and a look to the future

Excerpt

This year marks the 60th anniversary of the first clinical use of metformin for diabetes. From small beginnings (and despite a somewhat chequered history), metformin is currently recommended as the first-line oral glucose-lowering agent in most, if not all, clinical guidelines on the management of type 2 diabetes. Perhaps as a reflection of this, metformin was prescribed for 83.6% of individuals with type 2 diabetes in the UK in 2013 [1]. Meanwhile, in the USA, metformin was the eighth most commonly prescribed drug consistently from 2008 to 2012 [2], the number of prescriptions rising from 51.6 million in 2008 to 61.6 million in 2012. Metformin and gliclazide are the only two oral glucose-lowering agents on the WHO Model List of Essential Medications [3]. How did this drug reach such a commanding position and is such widespread use justified? …