One of the drugs used to treat type 2 diabetes is metformin. Metformin has been around for almost 50 years.
In the last two decades a lot of data has been published about metformin and its role in inducing weight loss and lowering the risk of heart disease.
The drug is readily available and is relatively cheap. As an oral hypoglycemic agent, it is very effective for type 2 diabetes. However, its ability to reduce the risk of heart disease is now been refuted.
Researchers from France working at the Clinical Investigator Center in Lyon looked at several large studies of metformin and its effect on the heart. What the researchers found was that metformin did not lower the risk of heart disease, as had been previously reported. (1)
This is a very surprising finding because metformin has been considered to be the first line drug for diabetes for more than a decade.
The initial work from the UK Prospective Diabetes Study published in 1988 showed a significant reduction in mortality in obese patients with diabetes when treated with metformin. Most physicians adopted the findings from this this study and started to prescribe metformin for their patients. (2)
Another surprising finding from the French analysis was that in non-obese patients with diabetes, metformin may actually increase the risk of death.
However, some researchers from the United States have criticized this study because the researchers only looked at studies which had followed metformin use for a short time period.
The French investigators only looked at four studies which followed patients for more three years. On the other hand, the UK study had followed patients over a period of more than 12 years.
In any case, the short term analysis by the French investigators still showed that metformin did not lower the risk of heart attacks, leg amputations, strokes and other diabetic complications.
So what should the consumer do?
For now, no one has ever shown that metformin can increase heart disease or induce heart attacks. It is an excellent drug for diabetes and seems to work well.
Moreover, metformin, unlike other oral hypoglycemics, does not cause hypoglycemia, weight gain or heart failure. For type 2 diabetics, it is still a great drug and should not be discontinued.
The one magic bullet to reducing risk of heart disease is to change lifestyle, and that means eating healthy, avoiding weight gain, not smoking and exercising on a regular basis.
Reliance on any one drug or a health supplement to lower risk of heart disease is definitely not recommended, because it only brings disappointments.
1. Boussageon R, et al "Reappraisal of metformin efficacy in the treatment of type 2 diabetes: a meta-analysis of randomised controlled trials."
2. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group.
Reviewed April 23, 2012
by Michele Blacksberg RN
Edited by Jody Smith