Abstract
Glucocorticoids have powerful anti-inflammatory and immunomodulatory effects, but
chronic use of these drugs can cause hyperglycemia, type 2 diabetes mellitus, hepatic
steatosis, obesity, and other complications due to their metabolic actions. Metformin
is a widely used drug for the treatment of type 2 diabetes mellitus with a known ability
to lower blood glucose levels. This review focuses on metformin's actions on glucose
metabolism and its potential use as a drug to limit the metabolic side effects of
glucocorticoid treatment. Available data suggest that metformin inhibits complex I
of the mitochondrial electron transport chain, crucial gluconeogenic enzymes, and
fatty acid synthesis that leads to a significant improvement in glucose tolerance
and maintenance of insulin sensitivity during glucocorticoid treatment. Three small
randomized control trials have demonstrated that metformin can limit changes in glucose
metabolism during treatment with prednisone. These studies reveal a promising potential
for metformin use as a therapeutic agent to reduce glucocorticoid-induced hyperglycemia
and improve patient outcomes.
Key Indexing Terms
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Article info
Publication history
Published online: May 03, 2022
Accepted:
April 22,
2022
Received:
July 8,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
