Metformin®

Metformin, a widely used medication for managing type 2 diabetes, has recently garnered attention for its role in extending a healthy lifespan. Research into metformin’s effects on aging has unveiled intriguing possibilities. Some studies suggest that metformin may influence cellular processes related to aging, such as reducing inflammation, improving insulin sensitivity, and promoting autophagy—where cells remove damaged components.

The primary mechanism of metformin involves several actions within the body:

  • Decreased Glucose Production: Metformin reduces the amount of glucose produced by the liver. In people with type 2 diabetes, the liver often produces excess glucose, contributing to high blood sugar levels. By inhibiting this process, metformin helps lower fasting blood sugar levels.

  • Enhanced Insulin Sensitivity: Metformin improves the body's response to insulin, a hormone that helps cells absorb glucose from the bloodstream. In individuals with insulin resistance (a common feature of type 2 diabetes), cells do not respond well to insulin, leading to elevated blood sugar levels. Metformin enhances insulin sensitivity, allowing cells to utilize insulin more effectively.

  • Decreased Intestinal Glucose Absorption: Metformin reduces the absorption of glucose from the intestines after eating, leading to lower post-meal blood sugar levels.

  • Promotion of Weight Loss: Metformin can help some people with type 2 diabetes lose weight or prevent weight gain. It may contribute to a feeling of fullness and reduce food intake in some individuals.

  • Blood Sugar Control: Metformin is highly effective in lowering and controlling blood sugar levels, especially fasting blood sugar. By regulating glucose production and improving insulin sensitivity, it helps individuals with type 2 diabetes maintain stable blood sugar levels.

  • Weight Management: Metformin is associated with modest weight loss or prevention of weight gain in some individuals. This can be particularly beneficial for people with type 2 diabetes who are overweight or obese.

  • Cardiovascular Health: Some studies suggest that metformin may have cardiovascular benefits, such as improving lipid profiles and reducing the risk of heart-related complications in people with diabetes.

  • Lower Risk of Certain Health Complications: Properly managed blood sugar levels with metformin can lower the risk of diabetes-related complications, including kidney disease, nerve damage, and eye problems.

  • Polycystic Ovary Syndrome (PCOS) Management: Metformin is often used to manage insulin resistance in women with PCOS, helping regulate menstrual cycles and improve fertility.

While it is generally considered safe and effective, like any medication, it can cause side effects in some individuals. Common side effects of metformin include:

  • Gastrointestinal Distress: One of the most common side effects is gastrointestinal upset, including diarrhea, nausea, vomiting, and abdominal discomfort. These symptoms often occur at the beginning of treatment and may subside over time.

  • Loss of Appetite: Some individuals may experience a reduced appetite or feelings of fullness.

  • Taste Disturbances: Metformin can cause a metallic taste in the mouth or a lack of taste sensation.

  • Lactic Acidosis (Rare): Although rare, metformin can potentially lead to a serious condition called lactic acidosis, characterized by the buildup of lactic acid in the bloodstream. This is more common in individuals with kidney or liver problems. Symptoms include difficulty breathing, muscle pain, sluggishness, and in severe cases, a drop in body temperature and heart rate. Anyone experiencing these symptoms should seek immediate medical attention.

  • Vitamin B12 Deficiency: Long-term use of metformin has been associated with a decrease in vitamin B12 absorption, potentially leading to a deficiency. Regular monitoring of vitamin B12 levels and supplementation if necessary is recommended.

  • Low Blood Sugar (Hypoglycemia) (in combination with other diabetes medications): Taking metformin in combination with other medications for diabetes can increase the risk of low blood sugar. Symptoms include shakiness, dizziness, sweating, irritability, confusion, and in severe cases, loss of consciousness.

  • Skin Reactions: Some individuals may experience mild skin reactions such as redness or itching.

It's important for individuals taking metformin to be aware of these potential side effects. If any side effects are experienced, it is crucial to inform a healthcare provider. Additionally, metformin should be used with caution in individuals with kidney or liver problems, as these organs play a role in the elimination of the medication from the body. Regular monitoring and dosage adjustments are typically done under medical supervision.