5 Lowering blood glucose with metformin in T2DM does not cause hypoglycaemia. 4 It acts as an antidiabetic drug via increasing peripheral glucose utilisation and peripheral insulin sensitivity as well as by reducing intestinal glucose absorption and hepatic glucose generation. Food and Drug Administration (FDA) in 1994, is currently recommended as the first-line pharmacological agent for newly diagnosed T2DM by the American Diabetes Association (ADA) 3 and by the European Association for the Study of Diabetes (EASD). Metformin is the most commonly prescribed oral antihyperglycaemic in the world and, after approval by the U.S. 1 Now, more than 40% of all incident patients are diabetic, while other classic nephrology disorders, such as glomerulonephritis, cystic kidney disease, and hypertension, have remained relatively steady as causes of ESRD over the past decade.
Over the past decade, the United States Renal Data System (USRDS) figures have demonstrated a progressive increase in the number of T2DM cases entering ESRD programmes. Type 2 diabetes mellitus (T2DM) is currently the main cause of chronic kidney disease (CKD) leading to end-stage renal disease (ESRD) in most countries around the world.
