PLEIOTROPIC EFFECTS OF METFORMIN: FROM CELLULAR TARGETS TO SYSTEMIC OUTCOMES

Metformin is the first-choice therapy to lower glycaemia and manage type 2 diabetes. Continuously emerging epidemiological data and experimental models are showing additional protective effects of metformin against a number of age-related diseases (ARDs), e.g., cardiovascular diseases and cancer. Metformin, classified as a biguanide oral antidiabetic agent, is predominantly prescribed as the primary treatment for type 2 diabetes mellitus. Its role as a therapeutic agent is expanding to include the treatment of pre-diabetes, gestational diabetes, polycystic ovarian disease and the treatment or prevention of preeclampsia. Beyond its primary role in regulating blood sugar, it also provides several secondary health advantages. These include protective cardiovascular effects, potential roles in managing COVID-19, assistance with weight control particularly in PCOS, and promising anti-cancer, anti-aging, and neuroprotective properties. This review summarizes recent studies supporting these diverse effects and discusses the methodologies of significant research efforts. Particular focus is given to metformin’s mechanisms of action, key clinical trials, and observational studies that demonstrate its extended therapeutic utility. Key words: Metformin, COVID-19, polycystic ovarian syndrome, anti-aging, neurodegenerative disorders, Galega officinalis.