The molecular pathology at Work: Metformin and Variability in Glycemic Control

sikandar hayat khan; Muhammad Qaiser Alam Khan; Asma Hayat; Asif Ali; Sajida Shaheen; Muhammad Younis; Muhammad Anwar; Eijaz Ghani

doi:10.51253/pafmj.v74i2.12070

Authors

sikandar hayat khan Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Qaiser Alam Khan Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (National University of Medical Sciences), Rawalpindi
Asma Hayat Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (National University of Medical Sciences), Rawalpindi
Asif Ali Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (National University of Medical Sciences), Rawalpindi
Sajida Shaheen Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (National University of Medical Sciences), Rawalpindi
Muhammad Younis Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (National University of Medical Sciences), Rawalpindi
Muhammad Anwar Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (National University of Medical Sciences), Rawalpindi
Eijaz Ghani Commandant, Consultant Virologist, Armed Forces Institute of Pathology (National University of Medical Sciences), Rawalpindi

DOI:

https://doi.org/10.51253/pafmj.v74i2.12070

Keywords:

Metformin, Metformin resistance, metformin response variability, pharmacokinetics of metformin, pharma-cogenetics of metformin, Type 2 Diabetes Mellitus

Abstract

Optimized management of type-2 diabetes mellitus (T2DM) remains a challenge not just because micro and microangiopathies’, chronic kidney disease, and infections related to poor cellular immunity. Methodology to manage T2DM remains in need for evolution to curb disease and help manage economy of diabetes care. Metformin remains the frontline soldier against T2DM. However, optimized and evidence-based use of metform for managing T2DM in clinics needs better molecular analytics to micro-precise medical management. We evaluated 353 manuscripts to finally shortlisted 45 reviews and RCTs using PRISMA guidelines from Google Scholar, PubMed and Cochrane Reviews. This systematic review attempted to identify the role of pharmacokinetic, pharmacogenomic, epigenetic and mitochondrial factors which can lead to sub-optimal diabetes management, metformin resistance and mutations which could lead to poor to no response to medicine. The most common mutations and polymorphisms in solute channels were observed to reduce the therapeutic efficacy/resistance

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