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Front Physiol. 2018 Jul 31;9:1039. doi: 10.3389/fphys.2018.01039. eCollection 2018.

Molecular Mechanisms of Metformin for Diabetes and Cancer Treatment.

Li M1, Li X1, Zhang H1,2, Lu Y1.

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Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.


Metformin has been the first-line drug treatment for hyperglycemia and insulin resistance for over 50 years. However, the molecular basis of its therapeutic role remained incompletely understood. Recent advances demonstrate that metformin could exert its glucose-lowering effect by multiple mechanisms, including activation of 5'-AMP-activated protein kinase, decreasing production of cyclic AMP, suppressing mitochondrial complex I of the electron transport chain, targeting glycerophosphate dehydrogenase, and altering the gut microbiome. In addition, epidemiological and clinical observation studies suggest that metformin reduced cancer risk in patients with type 2 diabetes and improved survival outcome of human cancers. Experimental studies have shown that this drug can inhibit cancer cell viability, growth, and proliferation through inhibiting mTORC1 signaling and mitochondrial complex I, suggesting that it may be a promising drug candidate for malignancy. Here, we summarize recent progress in studies of metformin in type 2 diabetes and tumorigenesis, which provides novel insight on the therapeutic development of human diseases.


AMPK; cancer; cell proliferation; gluconeogenesis; hepatic glucose production; mTOR; metformin; type 2 diabetes

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