Currently, metformin has become increasingly popular with both doctors and patients due to its widespread clinical use and its advantageous price. Metformin has been widely used in clinical treatment as the first-line drug for the treatment of diabetes, and diabetic patients need to have a comprehensive understanding of metformin in order to use it correctly. Advantages and effects 1. Excellent hypoglycemic effect and weight loss effect: Metformin can effectively control fasting blood sugar and postprandial blood sugar of diabetic patients and reduce the index of glycated hemoglobin by 1% to 2%. The mechanism of this effect of metformin includes: ① it can increase the sensitivity of surrounding tissues to insulin, enhance the use of glucose by insulin-mediated tissues, and increase the use of glucose by non-insulin-dependent tissues such as brain, blood cells, kidney, intestine and skin; ② it can inhibit hepatic glycogen isogenesis and reduce the output of hepatic sugar; ③ it can inhibit the absorption of glucose by intestinal wall cells. For many years, metformin has been the drug of choice for diabetic patients with relatively obese bodies, and its efficacy in reducing body weight and weight loss is no longer in doubt. Of course, non-obese diabetic patients taking metformin can also achieve good results. 2.It has the effect of cardiovascular protection. And can reduce the occurrence of macrovascular complications: metformin in addition to hypoglycemic effect, can also inhibit the synthesis of cholesterol, reduce triglycerides, total cholesterol and low-density lipoprotein cholesterol, so that the high-density lipoprotein cholesterol increases and can inhibit the oxidative stress state of cell death. This drug has been shown to be the only oral hypoglycemic drug that can control concurrent cardiovascular disease and reduce the chance of macrovascular complications in diabetic patients. In patients with type 2 diabetes requiring coronary revascularization, metformin administration significantly reduces the chances of infarction and mortality. Long-term follow-up survey shows that compared with patients using sulfonylurea glucose-lowering drugs, type 2 diabetic patients (including obese and non-obese) using metformin have reduced odds of complications of cardiovascular disease and mortality. 3, has the effect of improving insulin resistance: insulin resistance is one of the basic causes of diabetes, but also one of the focus of treatment of diabetes. Authoritative research shows that metformin is different from insulin or insulin-releasing drugs, which can lower blood sugar of diabetic patients while making their insulin levels significantly lower than the baseline level before treatment. This provides ample evidence that metformin improves the body’s sensitivity to insulin. Because of this, when metformin is taken alone by diabetic patients, it usually does not cause hypoglycemia. 4, has a good safety: metformin after half a century of application of diabetic patients, has been proved to be both effective and safe, can be said to have withstood the test of history. In the past, some people believe that taking metformin can increase the chance of lactic acidosis in patients, this reference is not evidence. A meta-analysis of the literature showed that no cases of lactic acidosis were found in 35,000 diabetic patients taking metformin, while individual reports of cases of lactic acidosis after taking metformin were often due to contraindications to taking metformin (e.g., renal insufficiency, heart failure, etc.) in those taking the drug. Side effects Generally, diabetic patients can experience adverse reactions such as diarrhea, nausea, vomiting, abdominal distention, and loss of appetite after taking high doses of metformin. However, these adverse reactions often resolve on their own after the patient stops taking the drug. Patients who take metformin for a long time can also lead to impaired absorption of vitamin B12, but it rarely triggers anemia. Who is suitable for taking 1.Improved glucose tolerance; 2.While treating through lifestyle adjustment, metformin can be used as a first-line therapeutic drug because it has multiple efficacy of weight loss, sugar reduction, cardiovascular protection and prevention of complications; 3.When taking sulfonylurea hypoglycemic drugs with poor efficacy, metformin can be taken at the same time to improve the efficacy; 4.In the application of insulin therapy 5.Adolescents with type 2 diabetes can take metformin alone or in combination with insulin when they are treated, which has been clinically proven to be effective and well tolerated, and has been approved by the U.S. and European Food and Drug Administration; 6.Elderly diabetic patients with normal renal function (over 80 years old) 6, elderly diabetic patients with normal renal function (creatinine clearance must be normal in patients over 80 years old) can take metformin for treatment, but must be taken under the guidance of a specialist.