Metformin has a long history as a substance with some medical value. It dates back even before its official recognition in 1918 for its ability to reduce blood sugar levels. Before any medical knowledge about diabetes, herbalists utilized a plant called Galega officinalis (also known as goat’s rue or French Lilac) to treat people who were urinating frequently, which is one of the main symptoms of untreated diabetes. Lately, research has shown that Metformin can be used for more than just diabetes.
Insulin is produced in the pancreas and plays a pivotal role in glucose metabolism to release energy. In diabetes, the pancreatic cells cannot produce sufficient insulin or have lost sensitivity to glucose levels, resulting in hyperglycemia (high blood sugar).Â
When diabetes was identified as a condition, attempts were made using guanidine, a component found in Galega officinalis, to decrease blood sugar levels. However, due to the toxic side effects coming from utilizing unaltered guanidine, prolonged treatment proved unfeasible. This scenario changed in the mid-20th century when scientists found ways of synthesizing newer forms of guanidine. The main benefit of Metformin (now based on synthetic dimethylbiguanide) as a way of treating diabetes came from its lower level of risk of inducing hypoglycemia (low blood sugar) compared to the main treatments of diabetes at that time, which were injectable insulin and sulfonylureas.
Metformin lowers glucose levels in three ways:
- By increasing the sensitivity of pancreatic cells to glucose, allowing them to take up glucose from the bloodstream more effectively.
- By lowering the levels of glucose being produced in the liver (gluconeogenesis) and switching to using stored sugars for energy
- By reducing the amount of glucose absorbed from food in the intestines.
Where Metformin shows promise in treating conditions other than diabetes.
Recent research suggests that Metformin, alone or combined with other medications, has value in treating diseases and conditions besides diabetes. While more studies are needed for confirmation, exciting possibilities for Metformin’s potential are emerging globally, including:-- Managing chronic liver diseases and cancers. Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths in the US due to rising cirrhosis rates. Metformin shows promise that it can play a preventive role against HCC among patients with diabetes and chronic liver disease, and it should even be continued in diabetic patients with cirrhosis.
- Improving resistance to the SARS-CoV-2 virus in obese or diabetic female patients to prevent severe COVID-19. One study analyzed information about over 6000 patients who had been hospitalized due to infection with COVID-19. While Metformin was not associated with any significant decrease in mortality overall, among women with type 2 diabetes or who were obese, there was an improved chance of survival when they were being treated with Metformin.
- Delaying the onset of dementia and Alzheimer’s Disease. Research suggests a link between metformin usage and dementia risk based on data comparisons of patients with diabetes taking metformin and those discontinuing the drug upon signs of kidney disease onset. Results showed an increase of 20% in the incidence of dementia diagnosis among those who stopped taking metformin. Another study involving individuals aged 50 years and above revealed a lower risk of dementia among metformin users compared to those treated with sulfonylurea medications.
- Reducing the rates of illness and death in individuals with pre-diabetes and existing heart conditions. This is the focus of a prolonged research study just starting because information so far indicates that Metformin shows promise in areas relating to cardiac conditions. While conclusive outcomes are not expected until the end of this decade, the significance lies in addressing heart disease, which stands as the leading cause of death among adults. The potential impact of treatments involving Metformin could be substantial.
