Use of metformin in pediatric age

Metformin is currently the most widely used drug worldwide for the treatment of type 2 diabetes (T2DM) in adults. Its primary action appears to be the inhibition of hepatic glucose production and the increase in peripheral insulin sensitivity (1). Due to the worldwide increase of pediatric obesity and its related complications (2-4), the adoption of treatment with metformin has significantly increased in children and adolescents. Whereas only short-term data are available on the benefits of metformin in obese children and adolescents with insulin resistance and normal glucose tolerance (5), metformin therapy in adolescents affected by T2DM is well established (6). Metformin is also beneficial in girls with polycystic ovarian syndrome (PCOS) (7). Moreover, the use of metformin has been recently extended to other conditions with promising results (8-10). This review summarizes scientific evidences and practical considerations for the use of metformin in the treatment of different diseases affecting children and adolescents.