Metformin is one of the most commonly used medications in endocrinology. It is the preferred first-line oral blood glucose-lowering medicine to manage type 2 diabetes. It is also used in the treatment of polycystic ovary syndrome. Sometimes it is used, along with other medications, to treat infertility.
The journal Diabetologia dedicated a special issue this month to Metformin, which is celebrating 60 years of clinical use.
Most people don’t know that metformin has been in use for sixty years! The effectiveness of the plant from which metformin is derived has been known since 1918. The plant Gallegos officinalis (goat’s rue, also known as French lilac or Italian fitch) was noted to have sugar-reducing properties then. Initial experiments with metformin went well, but the discovery of human insulin for the treatment of diabetes put metformin on the back-burner. Metformin was rediscovered in the 1940s. The French physician Jean Sterne was the first to pursue the glucose-lowering effect of metformin. He reported the use of metformin to treat diabetes in 1957.
Over the years, the ability of metformin to improve the way the body processes and responds to insulin was appreciated more and more through Europe. After intensive research, metformin was introduced into the USA in 1995.
Long-term benefits on heart health were identified by the UK Prospective Diabetes Study (UKPDS) in 1998. This provided yet another reason for metformin to become first-line treatment for diabetes.
Sixty years after its introduction, metformin has become the most prescribed sugar-lowering medicine worldwide with the potential for other uses.
1772 Galega officinalis used anecdotally to treat symptoms of diabetes
1929 First scientific experiments on lab animals
1957 Jean Sterne publishes on the use of metformin to treat diabetes
1958 Metformin introduced as a diabetes medication in the UK
1994 Metformin introduced in the USA
1998 UKPDS reports heart benefits of metformin in people with type 2 diabetes
2002 Metformin shown to reduce progression of prediabetes to diabetes
2011 Metformin included in the essential medications list of the World Health Organization
For further insights into the history and multiple uses of metformin – see Diabetologia (2017) 60