It is as effective as repaglinide and more effective than all other oral diabetes mellitus type 2 drugs. The American Diabetes Association and the American College of Physicians both recommend metformin as a first-line agent to treat type 2 diabetes. It is also used as a second-line agent for infertility in those with polycystic ovary syndrome. Metformin is used to lower the blood sugar in those with type 2 diabetes. 7.2.1 Combination with other medications.In 2019, it was the fourth-most commonly prescribed medication in the United States, with more than 85 million prescriptions. Metformin is the most widely used medication for diabetes taken by mouth. It is on the World Health Organization's List of Essential Medicines. It was introduced as a medication in France in 1957 and the United States in 1995. French physician Jean Sterne began the study in humans in the 1950s. It works by decreasing glucose production by the liver, by increasing the insulin sensitivity of body tissues, and by increasing GDF15 secretion, which reduces appetite and caloric intake. Metformin is a biguanide antihyperglycemic agent. It is not recommended in those with significant liver disease. High blood lactic acid level is a concern if the medication is used in overly large doses or prescribed in people with severe kidney problems. It has a low risk of causing low blood sugar. Common adverse effects include diarrhea, nausea, and abdominal pain. It is sometimes used as an off-label augment to attenuate the risk of weight gain in people who take antipsychotics as well as phenelzine.

It is not associated with weight gain and is taken by mouth.

It is also used in the treatment of polycystic ovary syndrome. Metformin, sold under the brand name Glucophage among others, is the first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight.

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