Every month, I’ll be highlighting Diabetes research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: What’s WRONG with Metformin?
Both my wife and I take the sugar-lowering type 2 diabetes medication, metformin. This blog was sparked by some concern an old friend of ours had. They wrote in a general “catch up” email: “Aren't there some new studies about how good metformin is? (Like maybe not so good?)”
So, I thought I’d check it out. I’m going to start with a doctor who apparently has questions about Metformin and has developed a HUGE line of alternative vitamins and supplements to use in place of Metformin. However, despite miles of glowing fabulous reviews about how wonderful his supplements are, he/the person in charge of his website, allowed this review to be published: “My experience with Dr. Ergin has been so opposite of these reviews that I question their veracity and/or source. To begin with, Dr. Ergin [ordered a] battery of tests he ordered did not provide an explanation of my symptoms, so a second round of the same test were ordered. Insanity, no? Frustrated I made an appointment with a GP who ordered a few additional test and was able to find the root of my symptoms. The difference I notice between the GP and Dr. Ergin is that medicine seems like a "calling" for the GP while Dr. Ergin seems overworked and pedantic. Afraid of making mistakes, he would be great for managing diabetes or thyroid problems but not for diagnostics. Beware." Additionally, “However, while the ingredients used are known, the products have not undergone third-party clinical trials…”
As with every medication, there are likely to be side-effects. The one I run across most often is called “in patients with advanced chronic kidney disease…may be susceptible to major adverse cardiovascular events (MACE), and end-stage kidney disease (ESKD)”. The thing here, is that it’s primarily people who have chronic kidney disease – and I doubt very much that it’s a common disease. [“15% of US population has chronic kidney disease” - https://www.cdc.gov/kidneydisease/basics.html#:~:text=15%25%20of%20US%20adults%20are,is%20about%2037%20million%20people.]
Obviously, they would avoid using Metformin. Center for disease control in Atlanta states: “CKD is common in people with diabetes. Approximately 1 in 3 adults with diabetes has CKD. Both type 1 and type 2 diabetes can cause kidney disease.” This seems a chicken and the egg – if a person is diabetic, they can eventually get CKD; but CKD causes MACE…so how do you know if you should continue or stop using metformin? Interesting…
What does metformin do and why is it important if keeping me healthy? Wikipedia states, “Metformin…is the main first-line medication for the treatment of type 2 diabetes…particularly in people who are overweight. Metformin is generally well tolerated, though may cause diarrhea, nausea, and abdominal pain, and there is a small risk of causing low blood sugar.
Metformin “…works by decreasing glucose production in the liver, [and] increasing the insulin sensitivity of body tissues…”. However, I found this as well: “The molecular mechanism of metformin is not completely understood.”
The physical aspects of how metformin acts were recently discovered (2020): “Metformin has been used for more than 60 years, and is the most frequently prescribed drug for diabetes in the world…A research team revealed that metformin promotes the excretion of blood sugar from the large intestine into the stool [this] may explain metformin's biological actions for which the underlying mechanism is unknown, and contribute to the development of new drugs for diabetes.”
So, we know how, we’re just not certain WHY. And as it’s been prescribed for the past 60 years, and the group of people who CANNOT take it is known, I’d say from this that YES: there are challenges and it’s not a “wonder drug”; but it does seem to be an effective tool in the current treatment of type 2 diabetes.
Links: https://www.practiceupdate.com/content/ada-2023-discontinuing-metformin-tied-to-worse-cardio-renal-survival-outcomes/154118; https://www.sciencedaily.com/releases/2020/06/200603100503.htm; https://en.wikipedia.org/wiki/Metformin
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