Perspectives on Diabetes Care

Facts about Metformin

Oct 4, 2012, 01:00 AM

I recently attended a really interesting presentation on Metformin.  Of course, I have been familiar with Metformin for many years. However, our speaker, Charles Reasner, MD, shared with us what I guess you would call “The Rest of the Story.” Here are some facts about Metformin.

• Metformin was described in the scientific literature starting around 1922.  It was first developed as an antiviral medication.  That did not work out so well, but the medication improved the blood sugar of those patients with diabetes. With the onset of insulin, which was touted as the cure for diabetes, Metformin was largely forgotten.
• From the French lilac, the name is derived from gluco (sugar) and phage (to eat).
• It was not until the 1950’s that Metformin was studied specifically for its use in diabetes.
• The UKPDS was one of the largest studies of its time with patients who were followed from 1977-1991.  The benefits of “good” glycemic control were proven as well as a renewed interest in the use of Metformin to lower glucose values while having low cardiovascular risk.
• Approved by the FDA in 1994, Metformin was brought to market by BMS on March 3, 1995.  (For some reason, it seems like Metformin has been around much longer than that!)
• Metformin has a low incidence of hypoglycemia.
• Metformin is the one diabetes drug which will either have no effect on patients’ weights or in some instanceswill help patients lose weight.
• Metformin is not metabolized in the body so it does not cause harm to any specific organ.
• Since Metformin is excreted unchanged through the kidneys, it is important that the kidney be functioning normally. The biggest risk of Metformin therapy is lactic acidosis if there are renal problems.
• Dr. Reasner reiterated several times that Metformin does not cause kidney damage nor does it cause lactic acidosis. The risk of lactic acidosis increases when Metformin builds up due to renal insufficiency. Thus, it is important to monitor kidney function when patients are taking Metformin.
• In 2008, a study suggested that Metformin appeared to reduce the formation of Alzheimer’s disease.
• This past summer, scientists were able to establish a connection between the use of the drug and the activation of certain pathways in the brain that encourage new cell growth and improved function. Metformin is now being looked at as a drug to perhaps treat Alzheimer’s disease.
• In the past few years, there has been “accumulating evidence” of a Metformin-cancer link. A recent Italian study showed a lower incidence of all forms of cancer – often by as much as 50 percent - especially a decrease in breast and prostate cancer.
• Most recently, a study showed that the risk of pancreatic cancer is 62 percent lower in patients taking Metformin.  This is huge as currently there are few options in the treatment of pancreatic cancer. This would most certainly warrant further investigation.
• Best of all, it’s very inexpensive costing only pennies a day.