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Metformin is considered to be the initial drug of choice for type 2 diabetes mellitus, particularly in overweight patients. This is based on its effectiveness in achieving glycaemic control, its favourable effects on weight, its low risk of causing hypoglycaemia and its reasonable cost. More importantly, metformin has also been consistently shown to have a favourable effect on cardiovascular risk factors, and to improve cardiovascular outcomes. It can be combined with other oral hypoglycaemic agents, as well as insulin, allowing for a beneficial additive effect.
This article provides a brief overview on the use of metformin, as recommended by the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA), in its 2012 guidelines for the management of type 2 diabetes.
Keywords: diabetes mellitus, metformin, oral hypoglycaemic agents, 2012 SEMDSA guidelines