Use of Metformin in Diseases of Aging

Overview

Journal Curr Diab Rep

Publisher Current Science

Specialty Endocrinology

Date 2014 Apr 23

PMID 24752835

Citations 13

Authors

John M Miles

Andrew D Rule

Barry A Borlaug

Affiliations

Soon will be listed here.

Abstract

Metformin is the most commonly prescribed medication for type 2 diabetes (T2DM) in the world. It has primacy in the treatment of this disease because of its safety record and also because of evidence for reduction in the risk of cardiovascular events. Evidence has accumulated indicating that metformin is safe in people with stage 3 chronic kidney disease (CKD-3). It is estimated that roughly one-quarter of people with CKD-3 and T2DM in the United States (well over 1 million) are ineligible for metformin treatment because of elevated serum creatinine levels. This could be overcome if a scheme, perhaps based on pharmacokinetic studies, could be developed to prescribe reduced doses of metformin in these individuals. There is also substantial evidence from epidemiologic studies to indicate that metformin may not only be safe, but may actually benefit people with heart failure (HF). Prospective, randomized trials of the use of metformin in HF are needed to investigate this possibility.

Citing Articles

Metformin Improves Glycemic Control and Postprandial Metabolism and Enhances Postprandial Glucagon-Like Peptide 1 Secretion in Patients With Type 2 Diabetes and Heart Failure: A Randomized, Double-Blind, Placebo-Controlled Trial.

Melenovsky V, Hoskova E, Velebova K, Veleba J, Borlaug B, Benes J Clin Diabetes. 2025; 43(1):23-32.

PMID: 39829685 PMC: 11739370. DOI: 10.2337/cd24-0003.

Incidence of metformin use in patients with age-related macular degeneration versus normal controls: A population-based study in Olmsted County, Minnesota.

Starr M, Dalvin L, AbouChehade J, Damento G, Garcia M, Shah S Eye (Lond). 2022; 37(9):1861-1865.

PMID: 36151313 PMC: 10275985. DOI: 10.1038/s41433-022-02245-6.

A new predictive model for the concurrent risk of diabetic retinopathy in type 2 diabetes patients and the effect of metformin on amino acids.

Song Z, Luo W, Huang B, Cao Y, Jiang R Front Endocrinol (Lausanne). 2022; 13:985776.

PMID: 36060930 PMC: 9434554. DOI: 10.3389/fendo.2022.985776.

Impact of Metformin Use on Survival in Patients Undergoing Liver Resection for Colorectal Cancer Metastases.

Kaltenmeier C, Morocco B, Yazdani H, Reitz K, Meyer K, Molinari M Am Surg. 2021; 87(11):1766-1774.

PMID: 34766506 PMC: 8666108. DOI: 10.1177/00031348211060445.

Accelerated Kidney Aging in Diabetes Mellitus.

Guo J, Zheng H, Zhang W, Lou W, Xia C, Han X Oxid Med Cell Longev. 2020; 2020:1234059.

PMID: 32774664 PMC: 7407029. DOI: 10.1155/2020/1234059.

References

Nichols G, Koro C, Gullion C, Ephross S, Brown J . The incidence of congestive heart failure associated with antidiabetic therapies. Diabetes Metab Res Rev. 2004; 21(1):51-7. DOI: 10.1002/dmrr.480. View

Nesto R, Bell D, Bonow R, Fonseca V, Grundy S, Horton E . Thiazolidinedione use, fluid retention, and congestive heart failure: a consensus statement from the American Heart Association and American Diabetes Association. October 7, 2003. Circulation. 2003; 108(23):2941-8. DOI: 10.1161/01.CIR.0000103683.99399.7E. View

Alpert M, Fraley M, Birchem J, Senkottaiyan N . Management of obesity cardiomyopathy. Expert Rev Cardiovasc Ther. 2005; 3(2):225-30. DOI: 10.1586/14779072.3.2.225. View

Huang E, Liu J, Moffet H, John P, Karter A . Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study. Diabetes Care. 2011; 34(6):1329-36. PMC: 3114320. DOI: 10.2337/dc10-2377. View

Rule A, Amer H, Cornell L, Taler S, Cosio F, Kremers W . The association between age and nephrosclerosis on renal biopsy among healthy adults. Ann Intern Med. 2010; 152(9):561-7. PMC: 2864956. DOI: 10.7326/0003-4819-152-9-201005040-00006. View

Misbin R . The phantom of lactic acidosis due to metformin in patients with diabetes. Diabetes Care. 2004; 27(7):1791-3. DOI: 10.2337/diacare.27.7.1791. View

Mohammed S, Borlaug B, Roger V, Mirzoyev S, Rodeheffer R, Chirinos J . Comorbidity and ventricular and vascular structure and function in heart failure with preserved ejection fraction: a community-based study. Circ Heart Fail. 2012; 5(6):710-9. PMC: 3767407. DOI: 10.1161/CIRCHEARTFAILURE.112.968594. View

DeBeck L, Petersen S, Jones K, Stickland M . Heart rate variability and muscle sympathetic nerve activity response to acute stress: the effect of breathing. Am J Physiol Regul Integr Comp Physiol. 2010; 299(1):R80-91. PMC: 5017870. DOI: 10.1152/ajpregu.00246.2009. View

Genev N, Lau I, Willey K, Molyneaux L, Xu Z, Zilkens R . Does insulin therapy have a hypertensive effect in type 2 diabetes?. J Cardiovasc Pharmacol. 1998; 32(1):39-41. DOI: 10.1097/00005344-199807000-00006. View

10.

Ekstrom N, Schioler L, Svensson A, Eeg-Olofsson K, Jonasson J, Zethelius B . Effectiveness and safety of metformin in 51 675 patients with type 2 diabetes and different levels of renal function: a cohort study from the Swedish National Diabetes Register. BMJ Open. 2012; 2(4). PMC: 3400073. DOI: 10.1136/bmjopen-2012-001076. View

11.

Wu M, Johnston P, Sheu W, Hollenbeck C, Jeng C, Goldfine I . Effect of metformin on carbohydrate and lipoprotein metabolism in NIDDM patients. Diabetes Care. 1990; 13(1):1-8. DOI: 10.2337/diacare.13.1.1. View

12.

Perriello G, Misericordia P, Volpi E, Santucci A, Santucci C, Ferrannini E . Acute antihyperglycemic mechanisms of metformin in NIDDM. Evidence for suppression of lipid oxidation and hepatic glucose production. Diabetes. 1994; 43(7):920-8. DOI: 10.2337/diab.43.7.920. View

13.

Coresh J, Astor B, Greene T, Eknoyan G, Levey A . Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis. 2002; 41(1):1-12. DOI: 10.1053/ajkd.2003.50007. View

14.

Scarpello J, Hodgson E, Howlett H . Effect of metformin on bile salt circulation and intestinal motility in type 2 diabetes mellitus. Diabet Med. 1998; 15(8):651-6. DOI: 10.1002/(SICI)1096-9136(199808)15:8<651::AID-DIA628>3.0.CO;2-A. View

15.

Jeppesen J, Zhou M, Chen Y, Reaven G . Effect of metformin on postprandial lipemia in patients with fairly to poorly controlled NIDDM. Diabetes Care. 1994; 17(10):1093-9. DOI: 10.2337/diacare.17.10.1093. View

16.

Sambol N, Chiang J, Lin E, Goodman A, Liu C, Benet L . Kidney function and age are both predictors of pharmacokinetics of metformin. J Clin Pharmacol. 1995; 35(11):1094-102. DOI: 10.1002/j.1552-4604.1995.tb04033.x. View

17.

Willi S, Martin K, Datko F, Brant B . Treatment of type 2 diabetes in childhood using a very-low-calorie diet. Diabetes Care. 2004; 27(2):348-53. DOI: 10.2337/diacare.27.2.348. View

18.

Stamler J, Vaccaro O, Neaton J, Wentworth D . Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993; 16(2):434-44. DOI: 10.2337/diacare.16.2.434. View

19.

Neumiller J, Setter S . Pharmacologic management of the older patient with type 2 diabetes mellitus. Am J Geriatr Pharmacother. 2010; 7(6):324-42. DOI: 10.1016/j.amjopharm.2009.12.002. View

20.

DeFronzo R . Pharmacologic therapy for type 2 diabetes mellitus. Ann Intern Med. 1999; 131(4):281-303. DOI: 10.7326/0003-4819-131-4-199908170-00008. View