Metformin: A Century-Old Diabetes Drug Finds New Life in India

As of November 2025, metformin, a diabetes drug first synthesized over a century ago, continues to play a crucial role in India's fight against the growing diabetes epidemic. Metformin, a 500 mg tablet costing barely a rupee, is the most prescribed oral medication for type 2 diabetes, taken by millions of people in the country every day.

Metformin's story is one of neglect, rediscovery, and eventual vindication. Its origins can be traced back to a herb called Galega officinalis, commonly known as French lilac or goat's rue, which was used in European folk medicine to treat people with sugary urine, an old description of diabetes. In the 1950s, French physician Jean Sterne recognized metformin's potential as a diabetes treatment and proposed the name "Glucophage," meaning "sugar-eater."

Metformin's unique mechanism of action sets it apart from insulin. Instead of directly driving glucose into cells, metformin reduces glucose production in the liver, enhances the body's sensitivity to insulin, and improves muscle glucose uptake. This results in lower blood sugar without the risk of weight gain or severe hypoglycemia, making it an ideal choice for India's diabetes management.

Despite initial setbacks, including the withdrawal of related drugs like phenformin due to safety concerns, metformin has emerged as the cornerstone of diabetes care in India. Its availability through government health schemes, ease of use, and lack of refrigeration or syringes requirements make it well-suited for India's public health system. Researchers have also discovered new potential uses for metformin, from treating polycystic ovary syndrome to delaying the onset of type 2 diabetes in high-risk individuals.