| Metformin, a biguanide drug, is widely prescribed to treat high
blood glucose in individuals with type 2 diabetes mellitus. Type
2 diabetes mellitus is a troubling chronic disease and diabetic
nephropathy is one of the most important complications of diabetes
mellitus. Recent studies suggest that metformin, in addition to
its efficacy in treating type 2 diabetes, may also have therapeutic
efficacy in other conditions, including diabetic nephropathy
or ameliorative property against tubular cell injury. Moreover,
metformin significantly decreases albuminuria in patients with
type 2 diabetes mellitus. However, the exact mechanisms beyond
the effect of metformin on blood glucose are still unknown. Recent
studies suggest that the therapeutic effect of metformin is mediated
by its action on adenosine monophosphate-activated protein
kinase in tissues. Various investigations show that metformin
decreases intracellular reactive oxygen species. Metformin protects
against tubular injury by restoring the biochemical alterations and
regulation of oxidative stress on renal tubules. It also protects
podocytes in nephropathy of diabetes. These findings can more
strongly potentiate the clinical use of metformin in the prevention
of nephropathy of diabetes. In this regard, to better understand
the metformin nephroprotective properties, more experimental rat
models and clinical studies are needed |