Journal of Social Issues and Health Sciences · Apr 6, 2026
Metabolic impacts of biguanides in the treatment of type 2 diabetes
By Cota KC
Introduction: Biguanides, especially metformin, are widely used in the treatment of type 2 diabetes mellitus (DM2) and are the first line of treatment for most patients. Objective: This study aims to investigate the metabolic and cardiovascular effects of biguanides, particularly metformin, in the treatment of type 2 diabetes mellitus. Methods: A systematic literature review was carried out of studies published between 2004 and 2024 in the PubMed, Web of Science, Scopus and Google Scholar databases. Original studies and reviews addressing the metabolic and cardiovascular effects of biguanides in the treatment of DM2 were included. Case reports, editorials, commentaries and studies focused on other medical conditions were excluded. Results and Discussion: Metformin improves insulin sensitivity, reduces hepatic glucose production and stabilizes or reduces body weight. In addition, it lowers the risk of cardiovascular events, improves the lipid profile, reduces systemic inflammation, improves endothelial function and may extend longevity. Studies indicate that metformin can also reduce the risk of certain types of cancer and improve the mental health of patients with DM2. Continuous treatment with metformin is associated with less progression of diabetic retinopathy. Conclusion: Metformin plays a crucial role in the treatment of DM2, offering benefits beyond glycemic control. The review highlights the importance of continuing to explore new agents derived from biguanides, with optimized safety and efficacy profiles, to further improve the management of DM2 and its complications.