Common diabetes drug linked to lower risk of death in major health study

For decades, doctors have relied on metformin to help people with type 2 diabetes manage their blood sugar levels. Now, new research suggests that this widely prescribed drug may offer benefits beyond blood sugar control.

Stanford University researchers found that adults with type 2 diabetes who took metformin before getting COVID-19 had a 39% lower risk of dying within a year of their infection than patients taking another type of diabetes medication.

The results, published in the journal Diabetes, Obesity and Metabolism, highlight potential protective effects that go beyond basic blood sugar control.

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High blood sugar can weaken your immune system, according to the Centers for Disease Control and Prevention. Metformin lowers blood sugar and helps the body use insulin more efficiently, although it is unclear whether these effects explain the study results.

A Stanford study of 53,332 U.S. adults with type 2 diabetes found that patients taking metformin before catching COVID-19 had a 39% lower risk of dying in the following year than those taking DPP-4 inhibitors. (iStock)

Researchers noted that the drug could help regulate a biological pathway involved in blood pressure and fluid balance that influences the severity of COVID-19. Previous studies have also indicated that metformin can reduce inflammation and lower virus levels in the body during an active infection.

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To assess the impact on long-term survival, the team analyzed US medical records of 53,332 adults with type 2 diabetes who tested positive for COVID-19 between October 2021 and November 2023.

All patients were aged 30 to 85 and had been prescribed either metformin or another diabetes medication, known as a dipeptidyl peptidase-4 inhibitor (DPP4i), at least a month before their diagnosis.

An independent epidemiologist noted that patients on metformin are generally healthier and younger than those receiving DPP-4 inhibitors, which are typically reserved for older patients or those with kidney disease. (iStock)

“Metformin is the first medication most people with type 2 diabetes receive. DPP-4 inhibitors usually come later or are given to people who cannot take metformin, often because they are older or have kidney disease or other health problems,” Ziyad Al-Aly, MD, senior clinical epidemiologist at Washington University in St. Louis, told Fox News Digital.

“Simply put, people on metformin are generally healthier than those on DPP-4 inhibitors,” added Al-Aly, who was not involved in the study.

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Most of the patients in the group, 50,965, were taking metformin, while 2,367 were taking a DPP4i. Patients on metformin were on average slightly younger, 60 years old compared to 64 years old for those on alternative treatment.

After adjusting for age, gender and other variables, researchers found that patients taking metformin were more likely to survive over the next year.

The data initially suggested a 13% drop in long COVID symptoms among metformin users, although further statistical testing found no statistically significant link. (iStock)

The data initially suggested a 13% drop in long COVID symptoms among metformin users, although further statistical testing found no statistically significant link.

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The new analysis aligns with other recent research, including a University of Minnesota Medical School study that showed patients who were prescribed metformin within six days of a COVID-19 diagnosis were less likely to die or develop long COVID.

“There is some evidence from the same group that metformin, given early in a COVID infection, can reduce the risk of long COVID, (but) this still needs to be confirmed in large, well-designed randomized trials,” Al-Aly noted.

The study authors and an external expert stressed that more clinical trials are needed and advised diabetic patients not to change their current medications based on these results. (iStock)

Because the Stanford review relied on existing medical records rather than a clinical trial, the authors cautioned that the study cannot prove that metformin directly caused the higher survival rate.

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Patients taking DPP4i drugs tended to be older and had more underlying health conditions, which could have contributed to their higher mortality risk, the researchers noted.

The team also lacked complete records of patients’ COVID-19 vaccination status.

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“This is not sufficient evidence to change treatment,” Al-Aly warned. “People take a DPP-4 inhibitor because they need it to control their diabetes, usually because metformin wasn’t enough for them or wasn’t an option for them.”

“No doctor chooses between these two drugs for the same patient. The comparison in this study does not constitute a real choice in any clinic. If you are taking either drug, do not change it because of this study.”