open access

Vol 72, No 2 (2021)
Review paper
Published online: 2021-04-30
Submitted: 2021-02-23
Accepted: 2021-02-27
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Metformin in patients with type 2 diabetes mellitus and heart failure: a review

Zofia M. Kułaczkowska, Marta Wróbel, Dominika Rokicka, Mariusz Gąsior, Krzysztof Strojek
DOI: 10.5603/EP.a2021.0033
·
Endokrynologia Polska 2021;72(2):163-170.

open access

Vol 72, No 2 (2021)
Review Article
Published online: 2021-04-30
Submitted: 2021-02-23
Accepted: 2021-02-27

Abstract

Diabetes mellitus is a major, global problem. Among the numerous complications of diabetes, there is increasing concern over the coexisting heart failure. Metformin is the most frequently used oral antidiabetic drug that is considered to be safe and effective in the management of type 2 diabetes mellitus. Since the publication of the UK Prospective Diabetes Study, it has been suggested that metformin might improve cardiovascular prognoses. Results from available studies have shown that metformin therapy in patients with type 2 diabetes mellitus and heart failure was associated with improved clinical outcomes when compared with other oral antidiabetic agents, insulin, or lifestyle management. However, there have been no randomized controlled trials evaluating the influence of metformin use on clinical outcomes in patients with type 2 diabetes mellitus and heart failure. New evidence from large cardiovascular outcome trials that showed a reduction in heart failure hospitalization for SGLT2 inhibitors caused changes in recommendations on the management of hyperglycaemia.

Currently, the European Society of Cardiology recommends sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus and heart failure or at high risk for heart failure, as a first choice in drug naïve patients, or as a second drug if the patient is already on metformin. The aim of our study is to review the current state of knowledge about the position of metformin in the treatment of patients with type 2 diabetes mellitus and heart failure. 

Abstract

Diabetes mellitus is a major, global problem. Among the numerous complications of diabetes, there is increasing concern over the coexisting heart failure. Metformin is the most frequently used oral antidiabetic drug that is considered to be safe and effective in the management of type 2 diabetes mellitus. Since the publication of the UK Prospective Diabetes Study, it has been suggested that metformin might improve cardiovascular prognoses. Results from available studies have shown that metformin therapy in patients with type 2 diabetes mellitus and heart failure was associated with improved clinical outcomes when compared with other oral antidiabetic agents, insulin, or lifestyle management. However, there have been no randomized controlled trials evaluating the influence of metformin use on clinical outcomes in patients with type 2 diabetes mellitus and heart failure. New evidence from large cardiovascular outcome trials that showed a reduction in heart failure hospitalization for SGLT2 inhibitors caused changes in recommendations on the management of hyperglycaemia.

Currently, the European Society of Cardiology recommends sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus and heart failure or at high risk for heart failure, as a first choice in drug naïve patients, or as a second drug if the patient is already on metformin. The aim of our study is to review the current state of knowledge about the position of metformin in the treatment of patients with type 2 diabetes mellitus and heart failure. 

Get Citation

Keywords

metformin; type 2 diabetes mellitus; heart failure

About this article
Title

Metformin in patients with type 2 diabetes mellitus and heart failure: a review

Journal

Endokrynologia Polska

Issue

Vol 72, No 2 (2021)

Article type

Review paper

Pages

163-170

Published online

2021-04-30

DOI

10.5603/EP.a2021.0033

Bibliographic record

Endokrynologia Polska 2021;72(2):163-170.

Keywords

metformin
type 2 diabetes mellitus
heart failure

Authors

Zofia M. Kułaczkowska
Marta Wróbel
Dominika Rokicka
Mariusz Gąsior
Krzysztof Strojek

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