Everything about metformin

This episode provides a high-level review of metformin, tracing its evolution from French lilac to the cornerstone of metabolic medicine. We explore its dual molecular mechanisms, balancing canonical AMPK-dependent pathways with non-canonical actions like mGPD inhibition and gut-brain axis modulation. The discussion reviews core clinical evidence from the UKPDS and DPP trials, examines its role in treating tissue-specific insulin resistance in polycystic ovary syndrome, and analyzes emerging data regarding mTOR inhibition in long COVID. Finally, we break down the pathophysiology of gastrointestinal distress, vitamin B12 deficiency, and the strict eGFR-based parameters required to mitigate the risk of lactic acidosis.