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Colegio de Medicina Interna de México.

2006, Número 5

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Med Int Mex 2006; 22 (5)


Biguanidas

Castro SD, Castro MMG

Idioma: Español
Referencias bibliográficas: 96
Paginas: 439-449
Archivo PDF: 300.88 Kb.


RESUMEN

La metformina es una biguanida que aumenta la sensibilidad a la insulina. Las biguanidas se usaron en Europa en la época medieval como tratamiento de la diabetes. La metformina y el fenformin se introdujeron en la década de 1950 pero, a finales de ese decenio pasaron a segundo término con la aparición de la insulina. La eficacia del control glucémico con metformina es similar al de las sulfonilureas, pero actúan de manera distinta. La metformina puede prescribirse como tratamiento adicional cuando la sulfonilurea sola no es suficiente ni adecuada. No obstante, las sulfonilureas incrementan las concentraciones plasmáticas de insulina mientras que la metformina las disminuye. La metformina se indica después de la falla del tratamiento con dieta en pacientes con diabetes mellitus no dependientes de insulina. Aunque la metformina se vincula con la acidosis láctica, se administra en más de 90 países y es el segundo fármaco oral antidiabético más prescrito después de la glibenclamida. La metformina es un fármaco inocuo si lo utilizan pacientes sin contraindicaciones.


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