Nowadays, biguanides have been well established as first line drugs for patients with type II diabetes. This is a class of drugs that doesn’t act by increasing insulin secretion, instead working on the utilization of glucose in the peripheral tissues so that there is a reduction of insulin resistance, which makes people fitter in the diabetic state. Going through the pathology of diabetes, there are two important features, one being the lack of insulin secretion, while the other is a lack of glucose utilization, thus allowing more blood glucose to accumulate. Insulin resistance has become a major issue for many diabetic patients and this is being countered by the use of metformin. This is the primary reason for its popularity among many physicians these days, replacing lots of other drugs. A few years back, sulphonylureas were primarily being used in the diabetes set up, however, biguanides have showed further advantages.

An important advantage of biguanides as an anti-diabetic drug is the lack of hypoglycaemic episodes that are found with other drugs. Such is a difficult situation for many patients, for which they need to have their food consumption at the right times. Sometimes, if the dosing is not accurate, there may be night time hypoglycaemia. All these issues are not found with this new drug in the market. This is because the mechanism of action is not in the pancreas. Instead, it acts on the peripheral tissues to utilize glucose.

Since the drug is more prominently working on the metabolism of glucose and storage in the muscles and adipose tissue, it is better than other drugs. Biguanides have therefore gained prominence in the present day scenario, as it acts on the muscles and adipose tissue. Consequently, there is no weight gain with the use of this drug, which is a side effect seen with other anti-diabetic drugs, especially the sulphonylureas. Rather, this drug supposedly promotes weight loss when taken with proper diet and with regular exercise.

Most diabetic patients suffer from macrovascular complications like coronary artery disease, renal problems, or retinal issues. There are also some microvascular complications. Biguanides are said to reduce these complications in the long run or delay their onset. This is an advantage that has been proven through a number of large scale trials.

Since patients with type II diabetes display a gradual loss of pancreatic beta cell functions, metformin has found to be useful in this regard as it doesn’t promote any such loss. Furthermore, there is an advantage in the reduction of HbA1C to a greater degree when taking this drug in comparison to many other drugs that are currently in use to treat diabetes. These ensure that this drug being taken by diabetics has lots of advantages because of its different mechanisms of action. It has positive effects on the body and is effective in the long run for patients as well.