Metformin Health Benefits: Why They Likely Go Beyond Type 2 … – Everyday Health

The medication has traditionally been used to help treat high blood sugar among people with type 2 diabetes, but it’s been shown to have a host of other benefits, too.
Historically, healthcare providers have prescribed metformin to treat high blood sugar for people with type 2 diabetes, but increasingly, emerging research suggests that the medication may hold promise for treating additional health conditions.
“It is mainly a medication for the treatment of diabetes,” says Marcio Griebeler, MD, an endocrinologist at the Cleveland Clinic in Ohio. “There are several studies that showed that metformin can decrease the long-term complications of diabetes, including cardiovascular events and cardiovascular mortality, myocardial infarction, heart failure, arterial revascularization, stroke, and death.”
In fact, a study published in May 2020 in the American Journal of Tropical Medicine and Hygiene suggested that metformin may also help reduce the risk of dying from COVID-19, the respiratory illness caused by the novel coronavirus, in people with type 2 diabetes. The study found that the death rate for participants taking metformin was 2.9 percent, while the death rate for those who didn’t take metformin was 12.3 percent. Yet it’s worth noting that this study was not a randomized controlled trial, so researchers could not prove that metformin alone was responsible for the reduced death rate. More studies are needed.
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With a relatively affordable price tag and ubiquity at pharmacies around the United States, you may be wondering if this drug may fit in your treatment regimen. In this detailed story, we run down the latest studies on the benefits of metformin, including its role in weight loss, and delve into the scientific reasons that metformin works.
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Metformin is a type of medication called a biguanide, which lowers blood glucose levels by decreasing the amount of glucose produced by the liver and promoting insulin absorption by muscle tissue, according to the American Diabetes Association.
Metformin became available in the United States in 1995, according to the Mayo Clinic, and it is the most commonly prescribed medication to treat type 2 diabetes worldwide, according to a study published in April 2019 in JAMA Insights. In fact, diabetes healthcare professionals consider metformin “the drug of choice for initial treatment of type 2 diabetes,” according to an article published in March 2017 in JAMA.
“Metformin is so popular because it is inexpensive and can reduce the glucose level and A1C [blood sugar average for three months] the most compared with other diabetes medications,” says Dr. Griebeler.
A review published in July 2014 in the Journal of Research in Medical Sciences reported that metformin is 30 percent more effective at reducing the risk of death and complications than insulin, glibenclamide, and chlorpropamide, which are sulfonylureas, a class of diabetes drugs.
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Metformin is generally part of a diabetes-maintenance plan, and it works in conjunction with a healthy diet and exercise routine. It’s usually taken twice a day with meals and can take anywhere from one week to two months to see blood sugar improvements, according to the Mayo Clinic.
Metformin is available under the brand names Fortamet, Glucophage, Glumetza, and Riomet, according to MedlinePlus. The U.S. Food and Drug Administration (FDA) has only approved metformin for people with type 2 diabetes, according to MedlinePlus. It’s also been shown to be a helpful preventive measure for people at risk of developing the disease and those with prediabetes, which is the precursor of type 2 diabetes, though the FDA has not yet approved metformin for those uses.
Susan L. Besser, MD, a diplomate of the American Board of Obesity Medicine and a primary care physician with Mercy Medical Center in Overlea, Maryland, says metformin is widely available — though by prescription only — and is relatively affordable. Griebeler says that in some locations, a three-month supply may cost just $10. It’s also known to be safe, with minimal side effects. Researchers behind a review published in August 2017 in the journal Drug Design, Development, and Therapy reported that it has a “good safety profile and is associated with low cost.”
RELATED: Does Metformin Cause Weight Loss? What to Know Before You Take It
Metformin is prescribed to treat high blood sugar, but researchers have found that it has many other benefits to offer patients with type 2 diabetes and can reduce the risk of several other health concerns, including:
RELATED: How Diabetes and Heart Disease Are Connected 
More and more research suggests that the benefits of this medication aren’t reserved for people with type 2 diabetes. Griebeler says that even though metformin is only approved for the treatment of type 2 diabetes, it’s being used off-label to treat weight reduction, polycystic ovarian syndrome (PCOS), infertility, prevention of diabetes, prevention of pregnancy complications, and obesity.
It’s been shown to have a positive effect on the following health issues for people without diabetes:
Osteoarthritis According to a study published in May 2019 in Arthritis Research and Therapy, metformin can help people with obesity and osteoarthritis. The researchers found that metformin helped people lose cartilage at a lower rate than those who did not take metformin, and they observed that the medication reduced participants’ risk of needing a total knee replacement, which is a possible complication of this health condition.
RELATED: Diabetes Drug May Protect Against Osteoarthritis Knee Damage
Alzheimer’s Disease A study published in April 2017 in Alzheimer Disease and Associated Disorders involving 20 people without type 2 diabetes found that metformin improved executive function skills, learning, memory, and attention. The randomized, controlled trial was short (eight weeks) and small (only 21 participants), though, so more research is needed.
Obesity Metformin has been shown to result in weight loss among people with type 2 diabetes, per the Mayo Clinic, so researchers were interested in seeing if the results would be similar for people without diabetes. “There has been some research that when people who [do not have diabetes but are] overweight are put on metformin, it helps with weight loss,” Dr. Besser says.
A study published in Experimental and Clinical Endocrinology and Diabetes treated 154 people who did not have diabetes with metformin for six months. The study participants lost nearly 13 pounds (lbs) on average, and researchers found that the medication helped overweight and obese people with insulin resistance, increasing their sensitivity to the hormone. Insulin resistance increases the risk for weight gain, notes the Mayo Clinic.
A meta-analysis of randomized, controlled trials that was published in December 2018 in Endocrine also found that metformin may help people with obesity lose weight. “I have used [metformin] for obesity management — for some with normal sugars, some prediabetic — and it helps,” Besser says. “It’s not an end-all, do-all — it’s not a miracle cure — but it does seem to help.” She says to expect only a modest amount of weight loss, 10 or 15 lbs, but it could be enough to inspire people to stay on the weight loss path. “It’s enough to kick-start things, and for anyone who’s quite overweight, any weight loss is encouraging, and it makes them want to keep going,” Besser says.
RELATED: 6 Foolproof Ways to Lose Weight for Diabetes and Heart Health
Arthritis A study published in 2019 in Current Rheumatology Reviews found that metformin can protect bones, especially during the early stages of rheumatoid arthritis, and decrease inflammation. “I suspect it’s because metformin may work in an anti-inflammatory way,” Besser says.
PCOS Metformin can help promote ovulation among nonobese women with PCOS, which, like type 2 diabetes, involves insulin resistance, according to an article published in June 2014 in the Annals of Translational Medicine. “Diabetes does not cause PCOS, but people with PCOS have a higher risk of developing diabetes,” Besser says. She’s used metformin to treat people with PCOS, a couple of whom managed to become pregnant after they started taking it. According to the Mayo Clinic, metformin can also improve fertility rates among women with PCOS.
RELATED: A Detailed Guide to PCOS Treatment Options
Though the FDA has only approved metformin to treat type 2 diabetes, research shows that it can help with a host of other health benefits for people with or without diabetes. In fact, according to a list of studies on the website for the journal Frontiers, in addition to the health conditions listed above, metformin is currently being explored as a way to treat these issues as well:
Additional reporting by Laura McArdle.
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