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Medicina Clínica (English Edition) Metformin: Paradigm of therapeutic pleiotropism (1922–2025)
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Review
Available online 7 November 2025
Metformin: Paradigm of therapeutic pleiotropism (1922–2025)
Metformina: paradigma de pleiotropismo terapéutico (1922–2025)
Alberto de Leiva Hidalgoa,
Corresponding author
, Ferran Morell Brotadb
a Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
b Vall d’Hebron Institut de Recerca, Servei de Pneumologia, Barcelona, Spain
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Table 1. Metformin: clinical uses and adverse effects.
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Table 2. Metformin: main actions, mechanisms and clinical benefits.
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Abstract

Werner and Bell synthesized metformin in 1922. In 2006, the International Diabetes Federation recognized metformin as the first-line drug for the treatment of type 2 diabetes. This review updates the pharmacological properties, adverse effects and therapeutic pleiotropism of metformin applied to the treatment of diabetes mellitus, gestational diabetes, polycystic ovary syndrome, appetite regulation, intestinal flora dysbiosis, cardiovascular and renal protection, treatment of idiopathic pulmonary fibrosis, reduction of risk and mortality from various neoplasms, and prolongation of lifespan.

Keywords:
Metformin
Diabetes
Gastrointestinal microbiota
Cardio-renal protection
Cancer
Longevity
Pulmonary fibrosis
Resumen

Werner y Bell sintetizaron la metformina en 1922. En 2006, la Federación Internacional de Diabetes reconoció a la metformina como el fármaco de primera línea en el tratamiento de la diabetes tipo 2. La presente revisión actualiza las propiedades farmacológicas, efectos adversos y pleiotropismo terapéutico de la metformina aplicada al tratamiento y prevención de diabetes mellitus, diabetes gestacional, síndrome de ovario poliquístico, regulación del apetito, disbiosis de la flora intestinal, protección cardiovascular y renal, tratamiento de la fibrosis pulmonar idiopática, disminución del riesgo y mortalidad por diversas neoplasias, y prolongación de la supervivencia.

Palabras clave:
Metformina
Diabetes
Microbiota gastrointestinal
Protección cardiorrenal
Cáncer
Longevidad
Fibrosis pulmonar

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