The commonly prescribed diabetes drug metformin has been shown to significantly affect metabolic pathways, according to German scientists.
Specifically, metformin was found to modulate the body’s nitrogen and urea metabolism following a study of patients with type 2 diabetes.
The findings were made by a research group from the Helmholtz Zentrum München and the German Diabetes Centre in Düsseldorf, who wanted to understand the molecular mechanisms that underlie the effects of metformin in the body.
Metformin, which is first-line treatment for people with type 2 diabetes, helps to lower blood glucose levels and increase insulin sensitivity. It has also been shown in previous studies to reduce the risk of cardiovascular complications and modulate cancer growth.
The German study team examined 353 ‘small’ molecules of participants who entered the population-based KORA study.
Patients with type 2 diabetes who were treated with metformin were compared to those not treated with the drug, and researchers evaluated differences in the distribution of metabolites in the blood.
They confirmed that metformin modulated the body’s nitrogen and urea metabolism following samples of more than 1,500 participants, and believe that changes in an amino acid called citrulline were particularly significant.
Those who took metformin had significantly lower levels of citrulline, which could be a consequence of metformin activating AMPK pathways, which play a key role in glucose regulation.
“Our analysis indicates that the activation of the AMPK pathway by metformin affects nitrogen and urea metabolism through a further enzymen, which thus lowers the citrulline levels,” said lead author Dr Rui Wang-Sattler.
The researchers now plan to analyse the associated effects of metformin on other metabolic pathways.
The results were published in the journal Diabetes.

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