The co-regulation of the gut microbiome and host genes might play essential roles in metformin gastrointestinal intolerance

Zhang, Huixiang; Lai, Jiao; Zhang, Lihuan; Zhang, Wei; Liu, Xun; Gong, Qilin; Tian, Hongxi; Yang, Mingzhi; Yang, Tao; Zhao, Rui; Li, Dongqing; Huang, Hehua; Zhao, Ya; Yan, Shan; Yu, Ming; Xiyang, Yanbin; Shi, Lanlan; Yang, Lirong; Wang, Limei; Chen, Weiwen; Cao, Xue

doi:10.1016/j.taap.2023.116732

Cited by 2 publications

(2 citation statements)

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“…Despite its widespread availability and affordability, metformin is associated with gastrointestinal side effects, including nausea, vomiting, diarrhea, and bloating, affecting around 20% of patients (Sanchez-Rangel and Inzucchi, 2017;Zhang et al, 2023). Approximately 5% of individuals stopped taking the medication because of negative reactions, and easing symptoms may be achieved by slowly decreasing the dosage (Sanchez-Rangel and Inzucchi, 2017;Schommers et al, 2017).…”

Section: Gastrointestinal Effectsmentioning

confidence: 99%

“…Approximately 5% of individuals stopped taking the medication because of negative reactions, and easing symptoms may be achieved by slowly decreasing the dosage (Sanchez-Rangel and Inzucchi, 2017;Schommers et al, 2017). Recent research has identified the gut microbiota as the primary factor behind the gastrointestinal side effects of metformin (Bonnet and Scheen, 2017;Zhang et al, 2023). Excessive gas production by E. coli may be linked to gastrointestinal discomfort in patients following metformin consumption (Forslund et al, 2015).…”

Section: Gastrointestinal Effectsmentioning

confidence: 99%

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Understanding the action mechanisms of metformin in the gastrointestinal tract

Cheng,

Ren,

Jia

et al. 2024

Front. Pharmacol.

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Metformin is the initial medication recommended for the treatment of type 2 diabetes mellitus (T2DM). In addition to diabetes treatment, the function of metformin also can be anti-aging, antiviral, and anti-inflammatory. Nevertheless, further exploration is required to fully understand its mode of operation. Historically, the liver has been acknowledged as the main location where metformin reduces glucose levels, however, there is increasing evidence suggesting that the gastrointestinal tract also plays a significant role in its action. In the gastrointestinal tract, metformin effects glucose uptake and absorption, increases glucagon-like peptide-1 (GLP-1) secretion, alters the composition and structure of the gut microbiota, and modulates the immune response. However, the side effects of it cannot be ignored such as gastrointestinal distress in patients. This review outlines the impact of metformin on the digestive system and explores potential explanations for variations in metformin effectiveness and adverse effects like gastrointestinal discomfort.

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