Metformin has been proven to be one of the most safe and effective antihyperglycemic agents. Through more than six decades of metformin use, it became the most studied hypoglycemic agent; through these studies, it showed a marvelous non-glycemic related effect. These effects include modulation of different points of cancer timeline, weight reduction, cardiovascular health, thyroid diseases, polycystic ovaries disease and many other medical conditions. The aim of this review was to assess the effect of metformin on non-diabetes related medical diseases. We have examined the studies published in PubMed and summarized different randomized controlled trials, observational trials and review articles. This review has summarized most of the non-glycemic effects of metformin. Metformin has been solidly shown to be effective in weight control with certain medications, effective in neuroprotection, in endothelial health, in control of anti-HIV agent side effects and many other crucial health jeopardies. The effects in cancer timeline modulation have taken the biggest part, since it was the most studied area outside the diabetes field. Having mentioned all the above privileges, and in addition to the robust evidence in glycemic control, this consolidates the position of metformin as a first line agent in treatment of diabetes and pre-diabetes. Perhaps in the near future, we may see other indications to use metformin in non-diabetes patients.

BackgroundSGLT2 inhibitors are a new class of drugs that act by inhibiting glucose reabsorption in the proximal renal tubules. Many trials have demonstrated their effectiveness in reducing glycated hemoglobin (HbA1c) and weight, but they have never been examined in Arab or Emirati populations.MethodsWe assessed the efficacy of SGLT2 inhibitors in reducing HbA1c and weight in our population and specifically in an Emirati cohort. We also assessed the effect on fasting blood glucose, blood pressure, lipid profile, serum creatinine, and side effects.ResultsThe total number of patients was 307. The baseline HbA1c in the Emirati cohort was 8.9±1.7%, which dropped significantly to 8±1.5% at 6 months (P = 0.0001). At 1 year, the mean HbA1c was 8±1.4%, which was significantly different from baseline (P = 0.0001). However, the change in mean HbA1c from 6 months (8±1.5%) to 1 year (8±1.4%) was not statistically significant (P = 0.88). A similar highly significant change was observed when comparing weights at baseline and 6 months in the Emirati population (85.7 ± 17.8 kg vs. 84 ± 17.2 kg, P = 0.0001). Total cholesterol dropped significantly at 6 months (P = 0.008), as did low-density lipoprotein (LDL) (P = 0.005).ConclusionsThe use of SGLT2 inhibitors is associated with significant reductions in HbA1c and weight. Unlike all previous trials, the inhibitors significantly reduced total cholesterol and LDL. Larger trials are needed to reassess their effects on lipid parameters.

Landmark trials on diabetes control have shown variable results in terms of cardiovascular benefits, with the majority showing a favorable effect of glycemic control on microvascular and, more recently, macrovascular complications. However, some trials pointed out a CV hazard with tight diabetes mellitus (DM) control. Most of those trials were assessing the impact of glycemic control, more than evaluating the effect of a certain medication. In the last decade, food and drugs administration (FDA) has mandated that all new hypoglycemic agents run a CV outcome trial (CVOT) for safety in order to grant and sustain approval. The most stunning results came from relatively new agents in the field of diabetes management, sodium-glucose cotransporter-2 inhibitors (SGLT2i) and the glucagon-like peptide-1 agonists (GLP-1 agonists), details of these CVOTs will be addressed later in this document. SGLT2i effect on the cardiovascular system remains an area of extensive research. We aimed in this review to summarize what is the current evidence of cardiovascular protection upon using SGLT2i. Moreover, we wanted to raise a point that may be strongly adopted in the future, combining SGLT2i plus GLP-1 agonists, having a cardiovascular privilege in both molecules.

Diabetes mellitus (DM) and depression are major global public health problems. Depression negatively affects the course of DM through hormonal, neuronal, or immune system changes that directly affect the body's ability to produce or use insulin. The coexistence of depression with DM also results in poor glycemic control by causing poor self-care behaviors such as lack of physical activity. The coexistence of depression with DM also results in poor glycemic control. The study aimed to assessing depression and Its associated Factors among diabetes mellitus patients attending the primary health care centers in United Arab Emirates. This study was conducted on 463 diabetic patients attended the primary health care centers during 8th may to 26th may, 2021. Nine primary health care centers were selected according to the accessibility. The Patient Health Questionnaire-9 (PHQ-9) was selected of the actual 9 criteria upon which the diagnosis of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) depressive disorders is based. Our study showed that there was non-significant difference in depression Levels between non-smokers and smokers, there was non-significant difference in depression Levels and education levels, there was significant difference in depression Levels and marital status, non-significant difference in depression Levels and nationality, non-significant difference in depression Levels and type of diabetes. Conclusion based on this study the prevalence of depression among female diabetes mellitus was high. From this study we concluded that depression levels: non-depressed, mild depression, moderate depression, moderately and severe depression are high in married participants comparing with single, divorced and widow participants