It is the most commonly used oral hypoglycemic drug, and in recent international and Chinese diabetes treatment guidelines, metformin is positioned as the first-line drug of choice for the treatment of type 2 diabetes, and is recommended as the only drug that can be used in combination with other types of oral drugs and insulin throughout diabetes. Do you know about this drug, which is so highly regarded by medical experts, and have you used it? Metformin has a very long history, like the Nobel Prize in medicine artemisinin comes from Artemisia annua, it is also derived from the extract of the plant forage goat bean. 1957 as a hypoglycemic drug first used in clinical practice, after more than 50 years of repeated verification, especially the epoch-making UK Prospective Diabetes Study (UKPDS) affirmed that metformin is the only hypoglycemic drug that can reduce macrovascular complications and reduce complications and mortality in type 2 diabetes. As research progressed, scientists gradually discovered that in addition to treating diabetes, metformin is beneficial in clinical settings for other conditions, such as improving insulin resistance in infertile patients with polycystic ovary syndrome, increasing the probability of ovulation and pregnancy by 3-4 times; helping to reverse fatty infiltration and improve liver function in NAFLD, and assisting in reducing the recurrence rate of pancreatic cancer. Metformin has been reported in the literature to reduce the incidence of lung cancer in nonsmokers, has the potential to prevent cataracts and treat the blinding disease uveitis, and has a potential role in reducing the prevalence of Parkinson’s disease. In December, the U.S. FDA just approved a clinical trial of metformin for the prevention of aging by Professor Nir Barzilai, who plans to follow 3,000 people over the age of 70 without diabetes for five years, focusing on the effects of metformin on cancer, heart disease and dementia. The study focused on the improvement of the incidence of cancer, heart disease and dementia. See the above content what do you have to say about metformin? The author encounters another scene with diabetic patients, almost every day I hear: “Metformin has big side effects, it will hurt the liver and kidneys, so I can’t take it”. So do you really know metformin? Here are some ideas for sugar lovers published in August 2014 in the Chinese Journal of Diabetes “Metformin Clinical Application Chinese Expert Consensus”. Metformin itself has no hepatic or renal toxicity and does not cause kidney damage. Proteinuria and renal insufficiency in diabetic patients are often complications of long-term hyperglycemia, and your treatment is inadequate. Like other drugs, metformin has to be metabolized and eliminated from the body through the liver and kidneys, if the liver and kidney function is already significantly worse, it will affect the metabolic excretion of metformin in the body, and the accumulation in the body can cause “lactic acidosis”. Experts tell us that liver function does not exceed three times the upper limit of normal value (such as transaminase 120U/L) can be used safely. Renal function depends on the blood creatinine indicator eGFR (estimated glomerular filtration rate), and metformin dose should be reduced only when it decreases significantly to eGFR<60ml, and should be stopped only when it reaches eGFR<45ml. The incidence of lactic acidosis is approximately 6 in 100,000 and is extremely rare. < p=""> A commonly seen clinical adverse effect of metformin is gastrointestinal distress (5%), including nausea, gastric distention, and diarrhea, which can be started at small doses (500 mg daily) and gradually increased, with the majority of patients tolerating the symptoms over several weeks. Long-term use of metformin may cause a decrease in vitamin B12 levels, and appropriate vitamin B12 supplementation is recommended for this population. Metformin is safe for all ages except for children under 10 years of age (no evidence of safe use). Metformin should also not be taken during diabetic ketosis, before and after the use of contrast examinations, or during severe cardiopulmonary insufficiency to avoid lactic acidosis. The above brief introduction shows that metformin is a very good commonly used hypoglycemic agent that improves insulin resistance, does not increase body weight and is not prone to hypoglycemia. It can be combined with other glucose-lowering drugs. There is no liver or kidney damage, and most of the gastrointestinal reactions are gradually tolerated. Sugar lovers can ask their physicians to arrange reasonable treatment according to the needs of their condition.