Metformin monotherapy for type II diabetes

In addition to controlling hyperglycemia, primary goals in treating patients with type II diabetes include relieving symptoms, diminishing complications and disorders that predispose to mortality, and improving quality of life. Following initiation of dietary and lifestyle modifications, drug therapy may be warranted to achieve adequate control of hyperglycemia. Until recently, sulfonylureas were the only first-line oral agents available in the United States. Unwanted effects such as hypoglycemia, weight gain, and increased fasting insulin levels have sometimes been associated with sulfonylureas, however. The biguanide metformin is an alternative oral first- line therapy for type II diabetes. With a mechanism of action distinct from that of the sulfonylureas, metformin improves glucose intolerance without stimulating insulin release or causing hypoglycemia. Additional benefits associated with metformin include a favorable influence on body weight and plasma lipid profiles. Metformin is an important first-line alternative agent for patients with type II diabetes.