Overview of metformin: special focus on metformin extended release

Introduction: Diabetes is characterized by chronic hyperglycemia and vascular alterations, leading to micro-vascular and macro-vascular complications, which account for increased morbidity and mortality associated with the disease. Cardiovascular complications are the leading cause of death in patients with diabetes. Due to its cardio-protective effects, metformin is recommended as the initial agent of choice in the treatment of T2DM. Results of UKPDS, one of the largest and longest studies, showed reductions in cardiovascular mortality in patients using metformin. Areas covered: This article reviews the history, structure, pharmacokinetics, clinical efficacy, and safety of extended-release metformin (XR). It also highlights fact that its use has been shown to have the same clinical and metabolic benefits as standard metformin, but also improved adherence and reduced side effects. The paper provides a side-by-side comparison of the main differences in the use of metformin XR versus metformin IR, i.e., the...