Ryan JO Dowling, Pamela J Goodwin and Vuk Stambolic*
Corresponding author: Vuk Stambolic firstname.lastname@example.org
BMC Medicine 2011, 9:33 doi:10.1186/1741-7015-9-33
(2011-05-12 11:37) Dept. of Occup. safety & hlth., Tampere, Finland
Dear Editor, This review summarizes in a very interesting way the many aspects of metformin effects.
While supporting the views expressed in the paper, I would like to mention that biguanidines
are inhibitors of the complex I in the mitochondrial respiratory chain. The inhibiting
effect might reduce the intracellular stress thereby sensitizing the cells to insulin
as described in the review. Another aspect is that the increased intracellular glucose also leads to increased
D-lactate formation (1)which may hamper many cellular functions. On the other hand,
the increased intracellular glucose concentration theoretically favors the so-called
Warburg effect (2). 1 Talasniemi JP, Pennanen S, Savolainen H, et al. Assay of D-lactate in diabetic plasma
and urine. Clin Biochem 2008; 41: 1099 2 Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: The
metabolic requirements of cell proliferation. Science 2009; 324: 1029
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