Metformin
-
David Sinclair, in his book, Lifespan, talks about the anti-aging, life-prolonging effects of metformin ("Glucophage"). In many countries this anti-diabetes drug is available over-the-counter, but is prescription only.
It seems that it might have other beneficial effects.
In work published in the New England Journal of Medicine, researchers—led by the University of Minnesota Medical School and School of Public Health—have found that metformin, a commonly prescribed diabetes medication lowers the odds of emergency department visits, hospitalizations, or death due to COVID-19 by over 40 percent—and over 50 percent if prescribed early in onset of symptoms. The study also found no positive effect from treatment with either ivermectin or low-dose fluvoxamine.
"We are pleased to contribute to the body of knowledge around COVID-19 therapies in general, with treatments that are widely available," said Carolyn Bramante, MD, principal investigator of the study and an assistant professor of internal medicine and pediatrics at the U of M Medical School. "Our trial suggests that metformin may reduce the likelihood of needing to go to the emergency room or be hospitalized for COVID-19."
Bramante noted that this was a secondary outcome of the trial; the primary outcome included whether someone had low oxygen on a home oxygen monitor, and none of the medications in the trial prevented the primary outcome.
The COVID-OUT trial was the nation's first to study whether metformin, a medication for type 2 diabetes; low-dose fluvoxamine, an antidepressant; and ivermectin, an antiparasitic, or their combinations could serve as possible treatments to prevent ER visits or hospitalization, as well as Long-COVID.
-
I was diagnosed with Type II DM about 5 years ago. I got my A1C down to below 5 with just diet and exercise.
About 3 years ago, when I saw my internist, Bob, I mentioned Sinclair's book and the talk of metformin. He told me that he had no problem putting me on it, so, here I am, on 500 mg a day.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
-
I was diagnosed with Type II DM about 5 years ago. I got my A1C down to below 5 with just diet and exercise.
About 3 years ago, when I saw my internist, Bob, I mentioned Sinclair's book and the talk of metformin. He told me that he had no problem putting me on it, so, here I am, on 500 mg a day.
-
Laying Some Spurious COVID-19 Treatments to Rest
Abigail Zuger, MD, reviewing Bramante CT et al. N Engl J Med 2022 Aug 18 Abdool Karim SS and Devnarain N. N Engl J Med 2022 Aug 18
A rigorous trial showed no benefits from ivermectin, metformin, or fluvoxamine.
Many repurposed drugs were thrown at SARS-CoV-2 early in the COVID-19 epidemic. Did any of them confer legitimate clinical benefit? Researchers constructed a rigorous trial to evaluate the antiparasitic agent ivermectin, the hypoglycemic agent metformin, and the selective serotonin reuptake inhibitor antidepressant fluvoxamine for treating patients with mild-to-moderate COVID-19. In vitro data, modeling data, and flawed clinical studies have been used to support their use.
Between December 2020 and January 2022, 1431 outpatients (mean age, 46) with proven COVID-19 entered a blinded, randomized, placebo-controlled, 2×3 factorial multicenter trial of these medications. All participants were overweight or obese (median body-mass index, 30 kg/m2) and had COVID-19 symptoms for about 5 days before enrollment. About half had been vaccinated against COVID-19, and only a minority had medical comorbidities.
None of the medications had any effect on a composite endpoint of hypoxemia, emergency room visits, hospitalizations, or death. In a subanalysis, metformin recipients had a slightly lower risk for emergency room visits, but no reduction in hypoxemia, hospitalization, or death. No effect on COVID-19 symptoms was seen with any drug, and no side effects were noted.
COMMENT
Despite results of some previous substandard clinical trials, none of these medications has a place in treating relatively low-risk outpatients with COVID-19. Further, as two editorialists point out, the dearth of side effects does not mean that use of these drugs is benign. Using them precludes use of proven effective COVID-19 treatments, and it diverts the supply of these medications from their legitimate uses. -
TOPLINE:
New research suggests terminating metformin may raise the risk for dementia in older adults with type 2 diabetes, providing more evidence of metformin's potential neuroprotective effects.
METHODOLOGY:
Researchers evaluated the association between discontinuing metformin for reasons unrelated to kidney dysfunction and dementia incidence.
The cohort included 12,220 Kaiser Permanente Northern California members who stopped metformin early (with normal kidney function) and 29,126 routine metformin users.
The cohort of early terminators was 46% women with an average age of 59 years at the start of metformin prescription. The cohort continuing metformin was 47% women, with a start age of 61 years.
TAKEAWAY:
Adults who stopped metformin early were 21% more likely to be diagnosed with dementia during follow up (hazard ratio, 1.21; 95% CI, 1.12 - 1.30), compared with routine metformin users.
This association was largely independent of changes in A1c level and insulin usage.IN PRACTICE:
The findings "corroborate the largely consistent evidence from other observational studies showing an association between metformin use and lower dementia incidence [and] may have important implications for clinical treatment of adults with diabetes," the authors write.
SOURCE:
The study, with first author Scott Zimmerman, MPH, University of California San Francisco, was published online October 25 in JAMA Network Open.
LIMITATIONS:
Dementia diagnosis was obtained based on medical records. Factors such as race, ethnicity, or time on metformin were not evaluated. Information on the exact reason for stopping metformin was not available.
-
I was diagnosed with Type II DM about 5 years ago. I got my A1C down to below 5 with just diet and exercise.
About 3 years ago, when I saw my internist, Bob, I mentioned Sinclair's book and the talk of metformin. He told me that he had no problem putting me on it, so, here I am, on 500 mg a day.
so, here I am, on 500 mg a day.
But what about the bad side effects?
Metformin seems to be really bad for fitness, and it lowers testosterone.
There's good human data on its downsides, whereas its upsides for aging are far less from clear.
For references, see
Link to video. I like the guy a lot in general. -
Interesting video. His point, to be stressed, is that he talks about non-diabetic patients.
There are so many drugs/supplements being hyped: CoQ10, resveratrol, NMN, ect. This guy promotes creatine. I'll take a look and see what data he presents for its efficacy.
As to me? Metformin got my HbA1C down to a good level (along with diet).
