Metformina – blaski i cienie jej stosowania u młodych pacjentów. Dylematy refundacyjne

*Ewa Otto-Buczkowska

Summary
Metformin is a well-established ingredient of diabetes management and the other with insulin resistance and disorders of glucose homeostasis conditions. Metformin used in over-weight or obese individuals with elevated fasting glucose and impaired glucose tolerance was associated with modest but durable weight loss and was safe and well tolerated over many years. Metformin lowers glucose and reduces risk for diabetes.
Metformin is a well-established oral hypoglycemic agent in the treatment of adults with type 2 diabetes mellitus and other conditions with insulin resistance. The beneficial role of metformin in young patients with type 2 diabetes has been demonstrated. Moreover, this agent acts favourably on blood pressure, lipids, haemostasis and other features of the metabolic syndrome. Metformin improves markers of insulin sensitivity and reduces BMI in children and adolescents with clinical insulin resistance or pre-diabetes.
Metformin is also beneficial in pediatric patients with type 1 diabetes mellitus and insulin resistance. Metformin treatment lowered HbA1c and decreased insulin dosage with no weight gain in teens with type 1 diabetes in poor metabolic control. Metformin can be safely combined with other classes of hypoglycaemic agents. Is also effective in young patients with polycystic ovarian syndrome, nonalcoholic fatty liver disease and some genetic syndrome. Among mechanisms of action metformin important is inkretin-lice effect.

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