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Page: Mechanism of Action
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The exact mechanism of action of metformin is uncertain despite its known therapeutic benefits. Its mode of action appears to be reduction of hepatic gluconeogenesis, decreased absorption of glucose from the gastrointestinal tract, and increased insulin sensitivity. The 'average' person with type 2 diabetes has three times the normal rate of gluconeogenesis; metformin treatment reduces this by over one third. It has also been shown to decrease intestinal absorption of glucose, and may also improve insulin sensitivity by increasing peripheral glucose uptake and utilization, although such an effect will occur nonspecifically following the lowering of glucose levels, regardless of how this lowering was achieved. A 2001 study showed that metformin stimulates the hepatic enzyme AMP-activated protein kinase (AMPK), which plays an important role in the metabolism of fats and glucose.
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