Metformin Use in High Risk Patients

Metformin may be beneficial for high risk patients

     According to a study in the Archives of Internal Medicine in November 2010, metformin was shown to decrease mortality in patients with pre-existing arterial disease. It decreased the risk of death by 24% in patients with documented cardiac or arterial disease.
The researchers attributed these affects due to metformin’s multiple sites of action, including decreasing insulin resistance, improving lipoprotein levels, and modestly reducing body weight, which are all proven risk factors for cardiovascular related deaths.

Using Metformin and Insulin Together

The Benefits of Metformin

    In past years, several short studies have found that adding metformin to the treatment plan of Type 2 diabetics who are already on insulin improved diabetes control, reduced the amount of insulin needed, and reduced weight gain. However, no long term studies had been done.
In March 2009, results of a 4.3 year study were published showing the long term benefits included weight loss and alleviating some diabetes complications, as well as blood glucose control. HbA1c was 0.4 percent lower, before and after meal glucose levels were lower, total insulin dose was decreased by 19.63 units, their BMI (body mass index) was 1.09 units lower, and their waist-to-hip ratio was lower. There was no significant lowering of CVD related measures (blood pressure, cholesterol, triglycerides).
Over time, blood glucose control declined in those patients taking insulin alone and those taking both insulin and metformin. This may just be a reflection of the progressive nature of diabetes. Along with other results, this may show that metformin may slow the progression, but not stop it.
The results of this study showed that for patients with Type 2 diabetes that are on insulin, taking metformin has many benefits that could lead to a longer and healthier life.
(Diabetes Self-Management Sept/Oct 2009)

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