Diabetes-Metabolism Research and Reviews最新文献

筛选
英文 中文
Mechanisms of action of metformin with special reference to cardiovascular protection. 二甲双胍对心血管保护的作用机制。
IF 8 2区 医学
Diabetes-Metabolism Research and Reviews Pub Date : 2019-10-01 Epub Date: 2019-07-24 DOI: 10.1002/dmrr.3173
Alexey V Zilov, Sulaf Ibrahim Abdelaziz, Afaf AlShammary, Ali Al Zahrani, Ashraf Amir, Samir Helmy Assaad Khalil, Kerstin Brand, Nabil Elkafrawy, Ahmed A K Hassoun, Adel Jahed, Nadim Jarrah, Sanaa Mrabeti, Imran Paruk
{"title":"Mechanisms of action of metformin with special reference to cardiovascular protection.","authors":"Alexey V Zilov, Sulaf Ibrahim Abdelaziz, Afaf AlShammary, Ali Al Zahrani, Ashraf Amir, Samir Helmy Assaad Khalil, Kerstin Brand, Nabil Elkafrawy, Ahmed A K Hassoun, Adel Jahed, Nadim Jarrah, Sanaa Mrabeti, Imran Paruk","doi":"10.1002/dmrr.3173","DOIUrl":"10.1002/dmrr.3173","url":null,"abstract":"<p><p>Management guidelines continue to identify metformin as initial pharmacologic antidiabetic therapy of choice for people with type 2 diabetes without contraindications, despite recent randomized trials that have demonstrated significant improvements in cardiovascular outcomes with newer classes of antidiabetic therapies. The purpose of this review is to summarize the current state of knowledge of metformin's therapeutic actions on blood glucose and cardiovascular clinical evidence and to consider the mechanisms that underlie them. The effects of metformin on glycaemia occur mainly in the liver, but metformin-stimulated glucose disposal by the gut has emerged as an increasingly import site of action of metformin. Additionally, metformin induces increased secretion of GLP-1 from intestinal L-cells. Clinical cardiovascular protection with metformin is supported by three randomized outcomes trials (in newly diagnosed and late stage insulin-treated type 2 diabetes patients) and a wealth of observational data. Initial evidence suggests that cotreatment with metformin may enhance the impact of newer incretin-based therapies on cardiovascular outcomes, an important observation as metformin can be combined with any other antidiabetic agent. Multiple potential mechanisms support the concept of cardiovascular protection with metformin beyond those provided by reduced blood glucose, including weight loss, improvements in haemostatic function, reduced inflammation, and oxidative stress, and inhibition of key steps in the process of atherosclerosis. Accordingly, metformin remains well placed to support improvements in cardiovascular outcomes, from diagnosis and throughout the course of type 2 diabetes, even in this new age of improved outcomes in type 2 diabetes.</p>","PeriodicalId":48934,"journal":{"name":"Diabetes-Metabolism Research and Reviews","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/3a/DMRR-35-na.PMC6851752.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信