Role of Genetic Polymorphisms in the Efficacy and Adverse Effects of Metformin in the Treatment of Type 2 Diabetes Mellitus

Abstract

A clinical diagnosis of diabetes mellitus type 2 (T2DM) may include hyperglycemia, reduced insulin production, and increased insulin resistance. Conventional treatments aim to reduce the severity of disease symptoms, but they are unable to reverse disease progression or cure it. Metformin is an anti-diabetic medication for lowering hyperglycemic conditions that can be used effectively as monotherapy or in combination with other oral hypoglycemic agents. However, significant inter-individual variability is seen in the response to metformin. Although a variety of factors can affect a patient's response to medication, understanding a patient's genetic makeup could be one of the most important steps toward developing precision medicine that is more secure and effective. Pharmacogenomics-based precision medicine can improve patients' responses to anti-diabetic medications and streamline the treatment. This review aims to provide general information about T2DM, treatment challenges, and pharmacogenetic aspects of metformin. In order to meet these objectives, several studies are discussed that investigated the association between gene polymorphism and altered therapeutic response to metformin.