Metformin: All You Need to Know About This Type 2 Diabetes DrugMonday, July 29, 2013
Did you know that the 2013 Standards of Medical Care in Diabetes published by the American Diabetes Association (ADA), recommended metformin as the preferred initial pharmacological agent for most people with type 2 diabetes? Another use for metformin is to help prevent or delay type 2 diabetes in people with pre-diabetes (impaired glucose tolerance, impaired fasting glucose or an A1C of 5.7-6.4 percent) with a body mass index greater than 35 kg/m2, or are 60 years of age or older and for women who have a history of gestational diabetes. Metformin is not recommended in people with contraindications to the medication or who cannot tolerate it.
Metformin falls under the biguanide class of diabetes medications. This class of medications helps to lower blood sugar by decreasing the amount of glucose made in the liver. It also helps fat and muscle cells use available insulin. When metformin is prescribed, it should be used as part of a lifestyle that includes exercise as suggested by ones physician and consuming a healthy meal plan that is individualized to help lose or maintain weight.
With approximately one in eight adults in the United States, which is approximately 29 million people, affected by type 2 diabetes, there are a lot of people taking metformin! In fact, metformin is not only used by many people in the United States, it is thought that it is the No. 1 prescribed diabetes medication in the world! If you are one of these people, it is wise to know as much as you can about the possible benefits of this medication, considered by some to be a wonder drug.
1. Possible Benefit: Preventing Cancer - According to the National Cancer Institute (NCI): “Metformin is being tested in clinical trials not only as a treatment for cancer, but as a way to prevent it in people at increased risk, including cancer survivors who have a higher risk of a second primary cancer.
The results of the Diabetes Prevention Program (DPP) in 2002 found that participants taking metformin had a substantially lower risk of developing cancer than the general population.
The NCI is a source of information on clinical trials researching the potential of metformin to possibly prevent many cancers. Colorectal, prostate, endometrial, and breast cancer are some of the cancers that are being studied. NCI is also collaborating with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to study participants from the landmark clinical trial, and the DPP, to investigate metformin’s impact on cancer incidence. Some of the trials are still open for participants. Please go here for information on NCI’s Consortia for Early Phase Prevention Trials.
2. Benefit: Metformin helps lower blood cholesterol and high triglyceride levels - By helping lower high cholesterol and triglyceride levels, metformin helps lower the risk of heart disease.
3. Potential Benefit: Slowing the Aging Process - The National Institutes of Health (NIH) has released a Funding Opportunity Announcement (FOA) to: support research projects in humans to “increase our understanding about the clinical translational potential of metformin to delay deleterious aging changes or to extend healthy human life span. This includes identification of specific populations particularly likely to benefit (i.e., in diabetic, as well non-diabetic populations), and/or to obtain information on metformin’s human physiologic and cellular effects that would be useful in identifying novel molecular targets.” For more information on this grant opportunity, click here.
The potential benefits of metformin are fascinating! Remember, metformin is not the drug of choice for people with contraindications to its use. These include moderate and severe kidney disease which may cause lactic acidosis or when there is not adequate oxygenation to the body or parts of the body, if dehydrated or with infections. Other reasons to avoid metformin may include impaired liver function. It also may not be recommended for some elderly patients, and for people that need to have a procedure using iodized contrast or are having surgery. People using metformin should avoid excessive alcohol consumption. Some people have severe gastrointestinal distress and cannot tolerate this medication.
Metformin can also decrease serum vitamin B12 levels. Ask your physician if your B12 levels are adequate.
Lastly, please discuss the use of metformin with your physician. If you think this medication may be for you or if you are taking it, ask about any contraindications or potential problems.