Farewell to Phenformin for Treating Diabetes Mellitus

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Abstract
Phenformin causes slight reduction of hyperglycemia, but controversy has existed concerning the mechanism. It may partially block absorption of glucose in the intestinal tract (1) and, under special circumstances, inhibits gluconeogenesis (2), but apparently these actions are relatively unimportant in the hypoglycemic action of phenformin in man. In in-vitro studies phenformin increased glucose uptake in isolated tissues in proportion to the amount of anaerobic glycolysis that it produced (3). The increased levels of plasma lactate in patients treated with this drug (4) suggests an increase in anaerobic metabolism. Phenformin has long been known to decrease insulin secretion (5). In view