Cited by 65Diabetes Treatment and ManagementMetabolism, Diabetes, and CancerNatural Antidiabetic Agents Studies

New Insights Into the Anti-Diabetic Actions of Metformin: From the Liver to the Gut

Wu, Tongzhi, Horowitz, Michael, Rayner, Christopher K.·2017·Expert Review of Gastroenterology & Hepatology

Abstract

INTRODUCTION: Metformin is established as the first-line therapy for type 2 diabetes (T2DM), but its mode of action remains elusive. Elucidation of the mechanisms underlying the anti-diabetic action of metformin may have the potential to optimise its glucose-lowering efficacy and lead to the development of agents acting on novel targets for the management of type 2 diabetes. Areas covered: This review highlights key pharmacokinetic features of metformin, summarises recent insights into its hepatic and gastrointestinal actions relevant to blood glucose homeostasis, and discusses the common gastrointestinal side effects of metformin. Literature concerning these areas was reviewed on PubMed. Expert commentary: The mechanisms by which metformin improves glycaemic control in type 2 diabetes are complex. Although novel hepatic pathways continue to be reported in preclinical studies, there is a lack of human evidence for most of these. Considering the fundamental role of the gastrointestinal tract in the regulation of blood glucose homeostasis and pleiotropic actions of metformin on several gastrointestinal targets relevant to glycaemic control, the gut is likely to represent at least as important a site of metformin action as the liver in the management of type 2 diabetes.

Integrity signals

Registry

Crossref · 10.1080/17474124.2017.1273769

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87 of 87 references verified0 citation errors · 0 not checkable

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Authors
Wu, T., Horowitz, M., & Rayner, C. K.
Affiliations
The University of Adelaide (AU)
Corresponding author
Wu, Tongzhi
Venue
Expert Review of Gastroenterology & Hepatology
Published
2016-12-26
Volume
11
Issue
2
Pages
157-166
ISSN
  • 1747-4124 (ISSN-L)
  • 1747-4132
OpenAlex
W2566304112
Cited by
64
References
88
Citations by year
2026: 1 · 2025: 10 · 2024: 8 · 2023: 7 · 2022: 8 · 2021: 7 · 2020: 10 · 2019: 6 · 2018: 5 · 2017: 2
FWCI
0.63
Type
journal article
Language
en
Open access
closed
Locations
  • Expert Review of Gastroenterology & Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
Keywords
metformin, type 2 diabetes, antidiabetic mechanism, blood glucose homeostasis, pharmacokinetics, gastrointestinal adverse effects, glycemic control
MeSH terms
Animals, Blood Glucose, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Liver, Metformin, Biomarkers, Treatment Outcome, Gastrointestinal Tract

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