Which medication is a Biguanide that decreases hepatic glucose production?

Which medication is a Biguanide that decreases hepatic glucose production?

• A. Acarbose
• B. Metformin
• C. Glimepiride
• D. Rosiglitazone

Answer: (B)

Metformin is a Biguanide whose main action is to lower blood glucose by decreasing hepatic glucose production. It does this primarily by inhibiting gluconeogenesis in the liver, a effect enhanced by activation of AMP-activated protein kinase (AMPK) in liver cells and by mild mitochondrial effects that shift cellular energy balance. This reduction in hepatic output lowers fasting glucose and helps reduce HbA1c, typically without causing hypoglycemia. It can also modestly decrease intestinal glucose absorption and improve insulin sensitivity in muscle and adipose tissue, adding to overall glucose control. The other drugs listed act differently: acarbose slows carbohydrate absorption in the gut; glimepiride increases insulin secretion from the pancreas; rosiglitazone improves insulin sensitivity via PPAR gamma but does not primarily suppress hepatic glucose production. Thus, metformin is the Biguanide that decreases hepatic glucose production.

Metformin is a Biguanide whose main action is to lower blood glucose by decreasing hepatic glucose production. It does this primarily by inhibiting gluconeogenesis in the liver, a effect enhanced by activation of AMP-activated protein kinase (AMPK) in liver cells and by mild mitochondrial effects that shift cellular energy balance. This reduction in hepatic output lowers fasting glucose and helps reduce HbA1c, typically without causing hypoglycemia. It can also modestly decrease intestinal glucose absorption and improve insulin sensitivity in muscle and adipose tissue, adding to overall glucose control. The other drugs listed act differently: acarbose slows carbohydrate absorption in the gut; glimepiride increases insulin secretion from the pancreas; rosiglitazone improves insulin sensitivity via PPAR gamma but does not primarily suppress hepatic glucose production. Thus, metformin is the Biguanide that decreases hepatic glucose production.