Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jul-Aug;26(10-12):427-441.
doi: 10.1080/14622416.2025.2565992. Epub 2025 Oct 1.

Genetics and response to treatment with metformin for type 2 diabetes

Laurence Tessier  1   2 , Sophie St-Amour  1   2   3 , Dorianne Simard  1   2 , Joanie Bouchard  1   2 , Patrice Perron  3   4 , Karine Tremblay  1   2   3
Affiliations
Review

Genetics and response to treatment with metformin for type 2 diabetes

Laurence Tessier et al. Pharmacogenomics. 2025 Jul-Aug.

Abstract

Diabetes is a chronic disease that affects approximately 589 million people worldwide. Type 2 diabetes is one of its main forms (~90%) and manifests as hyperglycemia due to the resistance of myocytes and adipocytes to insulin. These are unable to capture and use blood glucose. In the long term, T2D can lead to a reduced production of insulin by beta cells, leading to more complex complications. Metformin is the first-line treatment for this condition. However, it may not always be effective for regulating blood glucose levels. Some factors, such as genetics, may influence the drug efficacy for this disease. The aim of this review is to summarize the pharmacogenetic variants associated with response to metformin in T2D treatment.

Keywords: Type 2 diabetes; genetic variants; metformin; pharmacogenetics; precision medicine.

Plain language summary

Diabetes affects approximately 589 million people worldwide. Type 2 diabetes, one of its main forms (~90%), induces higher blood sugar which can be controlled by medication such as metformin. However, for some patients, metformin will not be able to decrease their blood sugar levels enough to reach normal levels. This response variability may be explained by genetic differences between individuals. Indeed, multiple genes were associated with response to metformin in type 2 diabetes, and more studies are needed to be able to predict this response.

PubMed Disclaimer

Conflict of interest statement

The authors report there are no competing interests to declare, and no artificial intelligence was used to conduct this literature review.

References

    1. Roses AD. Pharmacogenetics. Hum Mol Genet. 2001;10(20):2261–2267. doi: 10.1093/hmg/10.20.2261 - DOI - PubMed
    1. Whirl-Carrillo M, Huddart R, Gong L, et al. An evidence-based framework for evaluating pharmacogenomics knowledge for personalized medicine. Clin Pharma Ther. 2021;110(3):563–572. doi: 10.1002/cpt.2350 - DOI - PMC - PubMed
    1. Table of pharmacogenomic biomarkers in drug labeling. Center for Drug Evaluation and Research - FDA [Internet]. 2024. Available from: https://www.fda.gov/drugs/science-and-research-drugs/table-pharmacogenom...
    1. International Diabetes Federation Diabetes Atlas [Internet]. Diabetes atlas. 2025. [cited 2025 Apr 14]. Available from: https://diabetesatlas.org/
    1. Diabetes in Canada - Diabetes Canada [Internet]. Diabetes Canada website. 2025. [cited 2025 Apr 17]. Available from: https://www.diabetes.ca/en-CA/advocacy-policies/advocacy-reports/nationa...

MeSH terms

LinkOut - more resources