Metformin

Research from Harvard University shows that people with type 2 diabetes that are started on the drug metformin are less likely to need to progress onto further diabetes drugs to control their condition.

The study involved 15,516 patients that had been newly prescribed with their first medication for lowering their blood glucose levels. Only people who were started on tablet medications were included in the study. The average time of follow up for the patients was just over a year.

Whilst US guidelines recommend metformin as the first line of medication, only around 60% of participants were started on the drug. A quarter started on a sulfonylurea, 13% were started on a DPP-4 inhibitor (such as Januvia) and 6% on a thiazolidinedione (such as Actos).

Metformin may slow progression of diabetes

The results showed that out of the participants that were started on metformin, only 25% were put onto an additional drug within the study period. This compared with 40% of participants that were started on other drugs needing to be put onto an additional drug during the study period.

The increased likelihood of going onto another drug, compared with those that started on metformin was recorded as:

  • Started on sulfonylurea: 68% increased likelihood
  • Started on DPP-4 inhibitor: 62% increased likelihood
  • Started on thiazolidinedione: 61% increased likelihood

Metformin, sulfonylureas, DPP-4 inhibitors and thiazolidinediones all address the symptom of high blood glucose levels but the way metformin works may make it particularly advantageous for slowing the development of diabetes. Metformin works by targeting the liver, preventing it producing excess glucose and improving sensitivity to insulin.