Metformin in the therapy of type 2 diabetes mellitus bur dened by sarcopenic obesity in the elderly. Focus on pleiotropic effects

Progressive decline in muscle strength and body weight combined with excess body fat is predominantly found in the older age group and is one of the main signs of aging. Sarcopenia contributes to the progression of many chronic diseases, one of which is type 2 diabetes mellitus (DM2). The prevalence of DM2 in the elderly has increased dramatically in recent years, following the increase in the aging population, with sarcopenia occurring much more frequently in patients with DM2 and reported as a new complication. Based on the vast number of studies proving positive effects on skeletal muscle, cardiovascular disease outcomes, risk of malignant neoplasms and increased longevity, metformin has been proposed as a potential anti-aging drug. Metformin therapy may contribute to the prevention of age-related sarcopenia by regulating lipid metabolism in skeletal muscle, namely by enhancing lipolysis and reducing inflammatory responses through activation of AMPK — 5’-adenosine monophosphate-activated protein kinase. Studies conducted to evaluate the efficacy of metformin in individuals with sarcopenia confirm its positive effects on muscle strength and allow it to be considered for the treatment of sarcopenia.