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Wednesday 21 March 2012

Metformin, the marvellous survivor !

By Dr YAP PIANG KIAN

Metformin was first formulated in 1922. But unlike many drugs of the same era which have fallen by the wayside, it has endured, or indeed, thrived.


IN November 2011, I wrote an article entitled Aspirin, the New Wonder Drug for The Star. Aspirin is an ancient drug dating from 400BC, first used by Hippocrates for pain relief. Now it is standard treatment for the secondary prevention of heart attacks and strokes, and it is on the threshold of being used for the prevention of certain cancers.

Metformin is another candidate vying for the title of “wonder drug”.

But it is much newer, merely a few centuries old. It belongs to the biguanide class of antidiabetic drugs, and like many drugs, had its origins in folk medicine. Tea brewed from French Lilac or Goat’s Rue (Galega officinalis) was used to treat frequent urination and halitosis (a sweetish mouth odour). We now know that these are the symptoms of uncontrolled diabetes.

Metformin was first formulated in 1922. But unlike many drugs of the same era which have fallen by the wayside, it has endured, or indeed, thrived. It is now the most widely prescribed drug for diabetes worldwide.

In the last 10 years every guideline on diabetes has recommended it as the first line drug. But it was not always so... Let us start with its humble beginnings.

The following paragraphs have been abstracted from Wikipedia. “Metformin was first described in the scientific literature in 1922, by Emil Werner and James Bell. In 1929, Slotta and Tschesche discovered its sugar-lowering action in rabbits, noting it was the most potent of the biguanide analogues they studied. This result was completely forgotten soon after.

“Interest in metformin, however, picked up at the end of the 1940s. In 1950, metformin, unlike other similar compounds, was found not to decrease blood pressure and heart rate in animals. That same year, a prominent Filipino physician, Eusebio Y. Garcia, used metformin (he named it Fluamine) to treat influenza. He also noted the drug lowered blood sugar and was non-toxic. Garcia also believed metformin had bacteriostatic, antiviral, antimalarial, antipyretic and analgesic actions.

“French diabetologist Jean Sterne, working at Laboratoires Aron in Paris, was prompted by Garcia’s report to reinvestigate the blood sugar-lowering activity of metformin. Sterne was the first to try metformin on humans for the treatment of diabetes; he coined the name ‘glucophage’ (glucose eater) for the drug and published his results in 1957.”

So “glucophage”, now virtually a medical household name, was born, and this year, it is 55 years old! Generic forms of metformin are also widely available.

Full Article Here;

http://thestar.com.my/health/story.asp?file=/2012/3/18/health/10917209&sec=health

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