Endocrinology Service, Division of Subspecialty Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA. 2019 May 21;321(19):1926-1927. doi: 10.1001/jama.2019.3805.
Metformin is the first-line pharmacologic treatment for type 2 diabetes and the most commonly prescribed drug for this condition worldwide, either alone or in combination with insulin or other glucose-lowering therapies. Metformin is a biguanide, a drug class of herbal origin that has been widely used to treat diabetes since the 1950s. Two other biguanides were withdrawn from clinical use because they caused lactic acidosis. Metformin was also taken off the US market due to concerns over lactic acidosis, but it subsequently has been proven safe and effective in lowering glucose levels and was reintroduced in 1995. Optimal metformin use requires clear understanding of its effects, dosing, safety, and alternatives.
二甲双胍是治疗 2 型糖尿病的一线药物，也是全球范围内治疗该疾病最常用的药物，无论是单独使用还是与胰岛素或其他降糖药物联合使用。二甲双胍是一种双胍类药物，属于草药来源的药物类别，自 20 世纪 50 年代以来已被广泛用于治疗糖尿病。另外两种双胍类药物因引起乳酸酸中毒而被撤出临床使用。二甲双胍也曾因乳酸酸中毒问题而被撤出美国市场，但随后被证明安全有效，能降低血糖水平，并于 1995 年重新上市。要实现二甲双胍的最佳使用，需要清楚了解其作用、剂量、安全性和替代药物。
