Pharmacogenomics of Metformin- A Way to Personalised Medicine

Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease. There are atleast 10 different drug classes for the treatment of Type 2 diabetes mellitus (T2DM) but metformin is recommended as the initial medication for treatment of T2DM. Inter-individual variability in response and few clinical or biomarker predictors of response reduces its optimal use. Personalized medicine promises a path for individually optimized treatment, but realizing this promise will require a more comprehensive characterization of disease and drug response. As per American Medical Association, pharmacogenomics is the study of genetic variations that influence individual response to drugs. Knowing whether a patient carries any of these genetic variations can help prescribers individualize drug therapy, decrease the chance for adverse drug events, and increase the effectiveness of drugs. There are variety of genes controlling metformin transport in the body, for eg- SLC22A1, SLC22A2, SLC22A3, SLC22A4 etc. The purpose of this review article is to explain in brief pharmacogenomics of metformin and its application and practical hurdles in its translation.