Metformin is now considered as the only appropriate drug for patients with prediabetes and it is the first- line drug in type 2 diabetics. Besides significant antidiabetic effect, there are also important other effects of metformin, for example, reducing the incidence of cancer, positive cardiovascular effects, effect on ovulation, weight reduction effect and the effect on the intestinal microflora, such as reduced tumor incidence, cardiovascular positive effects, ovulation effect, weight reduction effect and intestinal microflora effect.
A number of recent publications show significant positive cardiac effects of metformin in type 2 diabetic cardiac patients. Losing position of metformin as a first-line drug for some patients in this year's ESC recommendations (2019), has disputed evidence-base.
Also in renal disease, metformin should not be restricted at this time, only its doses should be reduced. It is even considered that metformin may also be nephroprotective.
Certainly, however, it significantly reduces the high cardiovascular risk in patients with chronic kidney disease. It is therefore likely that metformin is an important drug in diabetes, not only of the past and present, but also of the future.