The Impact of Metformin on Neurological and Metabolic Function through Gut Microbiota

Metformin is an oral hypoglycemic agent and it is the primary medication for managing hyperglycemia. The relationship between metformin, gut microbiota and their combined effects on metabolic health and cognitive function remains inadequately explored, particularly concerning the modulation of gut microbes by metformin. Metformin recognized for its role in diabetes management, emerging evidence highlights its influence on gut microbiota and suggesting that its therapeutic effects extend beyond the gastrointestinal tract. The review delves into metformin’s capacity to modulate epigenetic pathways, including DNA methylation and histone modifications, thereby regulating gene expression related to inflammation and metabolism and modification of Key beneficial microbes, such as Akkermansia muciniphila and various Lactobacillus species, promoting systemic health through the production of SCFAs and modulation of gut-brain axis signaling. The role of gut microbiota in influencing neuroinflammation, cognitive function and metabolic health is well-explored in this review, revealing metformin’s potential to enhance cognitive performance, protect against neurodegenerative disorders and reduce neuroinflammation. This review provides critical insights into the mechanistic underpinnings of metformin’s actions, paving the way for future research on its broader applications in metabolic and cognitive health.