Metformin action: concentrations matter

Abstract

Metformin has been used for nearly a century and is now the most widely prescribed oral anti-diabetic agent worldwide. Yet how metformin acts remains only partially understood and controversial. One key reason may be that almost all previous studies were conducted with supra-pharmacological concentrations (doses) of metformin, 10-100 times higher than maximally achievable therapeutic concentrations found in patients with type 2 diabetes mellitus.