- Metformin appears safe for treating type 2 diabetes (T2D) in adults aged ≥60 years.
Why this matters
- T2D prevalence is increasing among the elderly, raising the concern that the first-line agent metformin could exaggerate the severity of aging anorexia.
- Meta-analysis of 6 randomized, placebo-controlled trials, including 1541 participants aged ≥60 years.
- Funding: Hungarian National Research, Development and Innovation Office.
- Raw body weight change difference between metformin and placebo groups was −2.23 kg (P<.001>
- HbA1c dropped by an average of 0.49 percentage points vs placebo (P<.001>
- Total cholesterol decreased significantly with metformin (−0.184 mmol/L; P<.001>
- Low-density lipoprotein cholesterol declined significantly following addition of metformin to other treatments (−0.182 mmol/L; P<.001>
- High-density lipoprotein cholesterol, serum triglycerides, and diastolic BP did not change with metformin.
- Mild gastrointestinal adverse effects/digestive tracts symptoms, nonsevere hypoglycemia, and discontinuation because of adverse effects appeared more common with metformin vs placebo in some studies.
- No subgroup or meta-regression analyses could be performed, i.e., by age group above 60.
- Dropout effects not always assessed.
- All studies performed in US or Western Europe.
- No data for those prescribed metformin for reasons other than T2D.
- Meta-analysis search focused only on body weight change, not lipids.