Metformin Combinatorial Therapy for Type 2 Diabetes Mellitus

Type 2 Diabetes mellitus (T2D) is a worldwide chronic epidemic with increasing incidence. The current algorithm for medical management of type 2 diabetes includes the pharmacological treatment with nine classes of anti-diabetic drugs. Among the nine classes of drugs approved, metformin, an oral hypoglycemic agent from the biguanide family is widely prescribed as the first-line anti-diabetic monotherapy for the treatment of initially diagnosed T2D individuals. The failure of monotherapy to achieve sustain glycemic control prompted the early use of aggressive combination therapies with other anti-diabetic drugs. The primary aim of T2D treatment is to achieve target glycemic control and reducing further complications of diabetes. Hence, fixed dose combination drugs are preferable in order to reduce pill burden and capital investment. Single pill combinations containing drugs for two different diseases can also be prescribed for avoiding extra medication and to reduce further diabetic complications. Our review addresses the mode of action of anti-diabetic drugs and their combinatorial therapy with metformin.