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Pengabdian Kepada Masyarakat

Prof. Dr. H. Askandar Tjokroprawiro, dr.,Sp.PD, K-EMD

diabetes@rad.net.id

Fakultas Kedokteran / Departemen Ilmu Penyakit Dalam

Tim Peneliti :

  1. Askandar Tjokroprawiro --> Peneliti Utama

Tahun : 2008

Halaman Naskah : 12 halaman

Sumber Dana : Mandiri

Besaran Dana : 1000000

SK. Penetapan :

Publikasi : Seminar : Improving Survival of Patients with Type 2 Diabetes How Can Do It Better?

Kategori Penelitian : Kesehatan

Posting : 11-03-2012

Visitor : 2327


Download Article : PDF 3028 byte.


Title :

Cardioprotective Properties of Metformin Treatment

Author : Prof. Dr. H. Askandar Tjokroprawiro, dr.,Sp.PD, K-EMD


Year : 2008

Abstact :

Metformin has been used in the management of type 2 diabetes mellitus (T2DM) for more than 40 years. Several clinical trials have evaluated metformin, either as monotherapy or in combination with a sulphonylurea, a TZD, or an insulin, in both naïve patients and in treated ones. The first strong indication of a potentially beneficial effect of metformin on the risk of diabetic vascular complications came from the UKPDS-35 report in the year 2000. Previously, UKPDS-34 (1998) reported that the addition of metformin in diabetic patients already treated with sulfonylureas appeared to be advantageous as a first-line pharmacological therapy. Consensus Statement of ADA / ESAD-2006 in the management of hyperglycemia in patients with T2DM, stated that lifestyle modification and metformin were initiated as the STEP-1 of treatment. Metformin has been used in the management of T2DM, IGT, and the MetS with DM (the MetS-DM), with its antihyperglycemic effect has been well-established. One study has provided evidence-based data to support metformin use in non-obese patients with type 2 diabetes mellitus. Minimally, 10 (ten) pleiotropic effects of metformin in reducing the risk of cardiovascular disease can be summarized and classified into 2 groups: 1. improved insulin sensitivity, fibrinolysis, hemorheology, nutritive capillary flow, postischemic flow, and 2. reduced hypertriglyceridemia, AGE formation, oxidative stress, cross-linked fibrin, and neovascularization. The fibrinolytic effects of metformin includes decrease in fibrinogen, tissue factor (F-VII), PAI-1, and F-XIIIa. Taken together, as illustrated in FIGURE-2, the author has compiled 27 pleiotropic properties of metformin. The activated AMPK (in liver and muscle) appears to be a critical step in the metformin-mediated reduction of hepatic glucose production and increase in skeletal muscle glucose uptake. In liver, it may result in decreased gluconeogenesis (decreased hepatic glucose product or fasting plasma glucose) and increased fatty acid oxidation, and decreased VLDL synthesis (decreased fatty liver and increased hepatic insulin sensitivity).


Keyword : Metformin,


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