Metformin appears to be safe in diabetic patients with heart failure

ECG readout

Heart failure is more prevalent in diabetes than in the general population.  All too often, patients with such serious co-morbidities are excluded from clinical trials.  As a result, there remains uncertainty around the benefits of diabetes medications in these sub-groups of patients.  Often, we need to look at observational data to get the best available [read the full story…]

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Review: more evidence needed for metformin in children with type 2 diabetes

A child tests her blood sugar

Metformin is usually the first line of active treatment for type 2 diabetes in adults. However, like many drugs its safety and effectiveness has not be adequately studied in children.  With more children being diagnosed as type 2, should metformin also be the first port of call for them? Clinical question: In children and adolescents [read the full story…]

Metformin may reduce the risk of cancer, but more research is needed

This systematic review looked at the relationship between oral antidiabetic drugs and the risk of cancer. Clinical question: In type 2 diabetes, does treatment with metformin or sulphonylurea affect the risk of cancer? The evidence: The reviewers found 17 observational studies reporting 37,632 cases of cancer.  When they pooled the data from these studies they [read the full story…]

Metformin may be associated with a reduced risk of liver cancer in type 2 diabetes

Several recent studies have suggested unexpected benefits of metformin.  This prompted a slew of meta-analyses looking for evidence of benefit in preventing cancer.  This evidence needs to be interpreted with caution; this latest review, looking at liver cancer, is a case in point. Clinical question: In type 2 diabetes, does metformin prevent liver cancer? The [read the full story…]

Lack of clear evidence for metformin in type 2 diabetes on insulin therapy

A pill

Metformin is widely used as a first line treatment for type 2 diabetes and it is usually continued when treatment is intensified, such as with other oral agents or by insulin therapy. This systematic review looked at whether metformin is actually beneficial to patients who are using insulin. Clinical question: In people with type 2 [read the full story…]

Unclear evidence on whether metformin reduces the risk of cancer in type 2 diabetes

Previous observational studies have suggested that use of metformin is associated with a reduction in the risk of cancer. This systematic review set out to clarify this question by incorporating the findings of recent trials. Clinical question: In people with type 2 diabetes taking metformin, what is the risk of cancer of any type? The [read the full story…]

Lifestyle changes aimed at preventing type 2 diabetes were cost-effective for improving quality of life.

A recent follow-up of a randomised trial looked at the long-term costs of different ways of preventing type 2 diabetes in people with impaired glucose tolerance. Clinical question: In people with impaired glucose tolerance and fasting hyperglycaemia, are lifestyle interventions, as compared to metformin or usual care, cost-effective? This paper reports the costs and quality [read the full story…]

In type 2 diabetes, use of metformin was associated with lower incidence of colorectal cancer.

The chemical structure of metformin

Laboratory research has suggested that metformin may inhibit cancer cell growth.  If it does, we would expect people treated with metformin to have a lower rate of cancer. This systematic review combined the data from five observational studies of patients with type 2 diabetes and studied the relationship between their use of metformin and incidence [read the full story…]