Why do people with polycystic ovary syndrome take metformin?

The human body is also likely to be troubled by a variety of polycystic diseases. There are many types of polycystic diseases, including kidney cysts, ovarian cysts, and uterine polycystic disease. All polycystic diseases are cystic diseases in the body. Some cysts are whole, and some are very small granular. They start as small as millet grains and gradually expand. Therefore, metformin needs to be taken for treatment on a regular basis.

Pharmacological Action

This product is a biguanide oral hypoglycemic drug. It has multiple mechanisms of action, including delaying the uptake of glucose from the gastrointestinal tract, increasing peripheral glucose utilization by improving insulin sensitivity, and inhibiting excessive gluconeogenesis in the liver and kidneys. This product does not lower blood sugar levels in non-diabetic patients. Patients usually lose weight during medication, and plasma cholesterol, triglyceride and pre-β-lipoprotein levels can be reduced, and peripheral glucose metabolism can be improved.

Hypoglycemic effect: This product has an accurate hypoglycemic effect and has no hypoglycemic reaction compared with sulfonylurea hypoglycemic drugs. It is effective for both obese and non-obese non-insulin-dependent diabetes mellitus (NIDDM) patients. For those who do not respond to simple dietary treatment, this product can be used alone to reduce their basal blood glucose concentration by ≥20% (generally 2mmol/L or 36mg/dl). It can improve oral or intravenous glucose tolerance test. Its hypoglycemic effect is unrelated to blood glucose concentration before medication, age, disease duration, body weight and basal insulin level. It is often used in combination with sulfonylureas for patients who cannot satisfactorily control their condition with sulfonylureas alone. The combined use can lower blood glucose by more than 20% compared with sulfonylureas alone. Combination with insulin can reduce insulin dosage.

Blood sugar lowering mechanism : ① The blood sugar lowering mechanism of this product is different from that of sulfonylureas. It does not stimulate insulin secretion. Its blood sugar lowering effect is mainly to increase the anaerobic glycolysis of sugar in the surrounding tissues and increase the utilization of sugar. The main site of this effect is in the small intestine. Animal experiments have confirmed that this product can increase the anaerobic glycolysis of the small intestine and increase the utilization of sugar in the jejunum by 20%.

② Inhibit hepatic glycogenolysis, which reduces basal blood sugar and lowers basal hepatic glucose output due to reduced glycogenolysis.

③ By increasing the binding of insulin to insulin receptors, it increases the blood sugar clearance effect of insulin. Since insulin resistance is a characteristic of NIDDM, this product improves the sensitivity of NIDDM patients to insulin by increasing the receptor binding sites of those with reduced insulin receptors and increasing the number of low-affinity binding sites. Animal experiments have shown that this product also has post-receptor effects, increasing insulin-stimulated glycogen production, increasing insulin receptor phosphorylation and increasing tyrosine kinase activity.

Other functions

Regarding lipid metabolism, this product can reduce the blood triglycerides of NIDDM patients by reducing very low density lipoprotein (VLDL) triglycerides, and can reduce them by 50% for those with hypertriglyceridemia. It can inhibit the biosynthesis and storage of cholesterol in the small intestine, reduce low-density lipoprotein cholesterol (LDL-cholesterol) and VLDL-cholesterol, and have a mild effect on lowering blood cholesterol.

Regarding the effects on blood vessels, animal experiments have shown that this product has anti-atherosclerotic effects, reduces the growth of arterial smooth muscle cells and fibroblasts, and increases blood flow in patients with peripheral vascular disease. Other clinical observations also show that it increases fibrinolytic activity and reduces sensitivity to platelet aggregating agents.

Taking this product will not cause NIDDM patients to gain weight, but can often lead to slight weight loss, especially for patients who strictly control their diet. According to clinical observations, obese patients lose an average of 1.2 kg after taking medication for one year, while those who take sulfonylurea hypoglycemic drugs (such as chlorpropamide) gain an average of 5.2 kg. There is no relationship between weight loss and the extent of its glucose-lowering effect, and the mechanism is still unclear.