Metformin is the main treatment for type 2 diabetes but research is also investigating its potential for other conditions, including PCOS
People taking Metformin, the primary treatment for type 2 diabetes, have been informed that it can deliver numerous additional beneficial effects – alongside some adverse ones. Writing on The Conversation website, Dipa Kamdar, Senior Lecturer in Pharmacy Practice at Kingston University, explained that it has helped millions manage their blood sugar levels, and has sparked renewed research interest in areas ranging from ageing and cancer to cardiovascular health and fertility.
The drug originates from a plant called galega officinalis, also known as French lilac or goat’s rue, which was originally used in folk remedies for symptoms now understood to be linked with diabetes, such as excessive thirst and frequent urination. During the early 20th century, scientists extracted blood sugar-lowering compounds from the plant, Ms Kamdar explained. Following years of development and clinical testing, metformin proved to be a relatively safe and effective treatment, and was launched in the UK during the late 1950s.
Clinical trials demonstrated that Metformin was successful at reducing glucose levels while also decreasing diabetes-related complications. It subsequently became the principal treatment for type 2 diabetes throughout much of the world.
Scientists are currently investigating whether Metformin could be beneficial for other conditions. Ms Kamdar said: “One common off-label use, meaning a medicine is prescribed for a condition it has not officially been approved to treat, is polycystic ovary syndrome (PCOS).
“Many people with PCOS have insulin resistance, which means their bodies do not respond properly to insulin and need to produce more of it to keep blood glucose stable. High insulin levels can stimulate the ovaries to produce more androgens, a group of hormones that includes testosterone.
“Raised androgen levels can disrupt ovulation and contribute to irregular or absent periods. By improving insulin sensitivity, metformin can help reduce these effects and may help regulate the menstrual cycle.”
Ms Kamdar revealed the drug was also being investigated for its potential impact on ageing and longevity. She said: “Although early findings are intriguing, there is still no conclusive evidence that it slows ageing in humans, and it is not approved for that purpose.
“Some research has suggested that metformin may have neuroprotective effects, meaning it could help protect the brain and nervous system, particularly with long-term use. But the evidence is inconsistent, and large, long-term clinical trials are still needed to determine whether metformin really can protect against dementia and other neurodegenerative diseases.”
Those taking Metformin may encounter side-effects, Ms Kamdar noted – amongst them nausea, stomach discomfort, diarrhoea, changes in taste, and loss of appetite. More seriously, users can also be affected by vitamin B12 deficiency, which has consistently been observed in people with type 2 diabetes who take metformin. “This may happen because the drug reduces how well vitamin B12 is absorbed in the gut.
“Over time, low vitamin B12 can lead to anaemia or peripheral neuropathy. Anaemia means the body does not have enough healthy red blood cells to carry oxygen properly, while peripheral neuropathy refers to nerve damage, usually in the hands or feet, that can cause tingling, numbness, pain or weakness.”
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