Have you ever wondered why certain medications are called “wonder drugs”?
Sometimes it is because of the enormous health benefits the medication provides for a particular condition, such as insulin for type 1 diabetes or antibiotics for pneumonia. Or it could be because the drug is good for many different conditions: Aspirin has often been called a wonder drug because it can relieve pain, treat or prevent cardiovascular disease, and even prevent cancer.
Could metformin join this list? It is approved in the US to treat type 2 diabetes when used with diet and exercise in people 10 years of age and older. But in recent years there has been increased interest in its potential to prevent or treat a variety of other conditions, including aging. Yes, get older. If that’s true, “wonder drug” might be an understatement.
What is metformin?
He history of metformin dates back hundreds of years. In Europe, the medicinal herb Galega officinalis was popular for digestive health and to treat urinary problems and other ailments. In 1918 a scientist discovered that one of its ingredients, guanidine, could reduce blood sugar. Guanidine-containing medications, such as metformin and phenformin, have been developed to treat diabetes. But they fell out of favor due to the serious side effects caused by phenformin and the discovery of insulin.
Metformin was rediscovered decades later and approved as a treatment for diabetes in Europe in the 1950s. It was not until 1995 that the FDA approved its use in the United States. Since then, it has become the most prescribed medication for people with diabetes who cannot control their blood sugar with diet and exercise alone.
Metformin’s Benefits May Extend Far Beyond Diabetes
For decades we have known that metformin does more than just help lower blood sugar in people with diabetes. It also offers them cardiovascular benefitsincluding lower rates of death from cardiovascular disease. And sometimes it helps people with diabetes lose excess weight.
Metformin may also have health benefits for people who do not have diabetes. Doctors have long prescribed it off-label, that is, to treat conditions outside its approved use, including:
- Prediabetes. People with prediabetes have high blood sugar that is not yet high enough to qualify as diabetes. Metformin can delay the onset of diabetes or even prevent it among people with prediabetes.
- Gestational diabetes. Pregnant women can develop high blood sugar levels that return to normal after delivery. Metformin can help control blood sugar during pregnancy in such women.
- Polycystic ovary syndrome (PCOS). This disorder tends to affect young women whose ovaries develop multiple cysts. Menstrual irregularities and fertility problems are common. Although the results of clinical studies are contradictory, Metformin has been prescribed for years. for women with polycystic ovary syndrome to help with menstrual regulation, fertility and high blood sugar.
- Weight gain due to antipsychotic medications. Antipsychotics are powerful medications prescribed for psychiatric illnesses such as schizophrenia. A common side effect is significant weight gain. Metformin can decrease weight gain among some people taking these medications.
Additionally, researchers are investigating the potential of metformin to
Because the vast majority of research on metformin included only people with diabetes or prediabetes, it is not clear whether these potential benefits are limited to people with those conditions or whether people without Diabetes can also reap benefits.
What about the side effects?
The safety profile of metformin is quite good. Side effects include nausea, upset stomach, or diarrhea; these tend to be mild. More serious side effects are rare. They include severe allergic reactions and a condition called lactic acidosisa buildup of lactic acid in the bloodstream. The risk of this occurring is higher among people with significant kidney disease, so doctors tend to avoid prescribing metformin for them.
The final result
Metformin is a first-line treatment for type 2 diabetes, according to current diabetes guidelines. It is relatively inexpensive and its possible side effects are well known.
If you have diabetes and need metformin to help lower your blood sugar, its other potential health benefits are a wonderful, not harmful, side effect. What if you don’t have diabetes? Well, its role in preventing or treating disease, and possibly even slowing aging and extending life expectancy, is much less clear.
While the research so far is promising, we need more convincing evidence before supporting its widespread use in people without diabetes. But for clinical researchers hoping to repurpose an old drug into a new wonder drug, metformin would seem like a good starting point.
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