Metformin is probably the most generally prescribed glucose-lowering medication on the planet, and it’s steadily used as a first-line remedy for kind 2 diabetes.
Though the drugs is at the moment solely formally permitted by the U.S. Meals and Drug Administration (FDA) for treating kind 2 diabetes, you might have heard about folks with kind 1 diabetes being prescribed metformin off-label.
In that case, you might be questioning whether or not folks with kind 1 diabetes can take metformin, whether or not this association is secure, and the way metformin works for folks with kind 1.
This text will examine the usage of metformin for kind 1 diabetes and reply some widespread questions you may need about the usage of metformin in kind 1 diabetes.
Key Factors:
- Metformin, when used for kind 1 diabetes, is at all times administered alongside insulin remedy, because it can’t exchange the essential operate of insulin in managing blood glucose ranges in kind 1 diabetes.
- Metformin may also help cut back insulin resistance and help in weight administration for folks with kind 1 diabetes, however it additionally carries potential unintended effects like gastrointestinal discomfort, highlighting the necessity for medical supervision in its use.
- In the end, whereas metformin presents potential advantages for these with kind 1 diabetes, its use must be rigorously thought of and guided by a healthcare skilled, tailoring remedy to every individual’s distinctive well being wants and targets.
Why would somebody with kind 1 diabetes wish to take metformin?
Individuals with kind 1 diabetes could also be prescribed metformin off-label (in a means not permitted by the FDA) to assist cut back insulin resistance (a situation through which the physique doesn’t use insulin effectively), to assist higher handle blood sugar ranges, and in some circumstances for weight reduction (often because of addressing insulin resistance).
A number of scientific trials and meta-analyses have proven that taking metformin can result in modest weight reduction. Though this isn’t the commonest motive individuals are prescribed metformin, the drug is thought to cut back urge for food and assist the physique be barely extra metabolically environment friendly, which may result in weight reduction over time.
Regardless that trials have proven that HbA1c ranges (a measure of glucose management over the earlier 2 to three months) don’t change considerably for folks with kind 1 diabetes who begin taking metformin, analysis has discovered that including metformin to an present insulin routine may also help cut back the quantity of insulin folks must take every day.
For folks with kind 1 diabetes, metformin is at all times used along side insulin remedy.
Can metformin exchange insulin?
It’s not secure for folks with insulin-dependent diabetes to try to switch insulin with metformin.
Administration of kind 1 diabetes requires insulin remedy. It’s because if in case you have kind 1 diabetes, your pancreas produces no insulin.
This hormone is essential for survival, so it should be externally administered (through injection or infusion) to take care of regular blood sugar ranges and make sure the physique’s cells obtain the glucose they want for vitality.
With out insulin remedy, folks with kind 1 diabetes can’t regulate their blood glucose ranges, resulting in critical well being issues. Due to this fact, insulin remedy isn’t just a remedy however a life-sustaining necessity for folks with kind 1 diabetes.
Metformin can considerably assist decrease blood sugar ranges, however it doesn’t improve or restore the physique’s means to supply insulin.
It’s vital to seek the advice of together with your physician about drugs you’re taking to ensure your prescriptions and plan of care are updated and to assist stop unintended interactions.
However both means, metformin won’t enable folks with kind 1 diabetes to cease taking insulin.
Is taking insulin higher than taking metformin?
Neither insulin nor metformin is superior to the opposite. Somewhat, they operate in several methods to assist decrease blood sugar ranges and will be complementary in sure conditions.
Metformin is a each day, or twice each day, oral medicine that comes within the type of a capsule. There are lots of manufacturers of metformin, together with a wide range of mixture medication that embrace metformin as one of many remedies.
There are additionally many sorts of insulin, that are both injected or administered subcutaneously (below the pores and skin) by an insulin pump (or within the case of the ultra-rapid-acting insulin Afrezza, inhaled).
Professionals and cons of metformin and insulin
Insulin is a vital hormone that helps sugar from the blood enter the physique’s cells for use as vitality. As a normal matter, insulin helps to carry down blood sugar ranges sooner than metformin can.
Metformin is assumed to work by lowering the discharge of glucose from the liver and growing insulin sensitivity within the muscle mass.
Regardless of their advantages, as with all medicines, there are additionally downsides to each metformin and insulin.
Insulin is a strong hormone, and taking an excessive amount of could cause low blood sugar (hypoglycemia), which will be very harmful, and probably deadly, if untreated.
Metformin could cause abdomen discomfort, diarrhea, and different digestive points, particularly if the dose is simply too giant or whether it is taken on an empty abdomen.
Scientific trials over a few years have established that when metformin alone isn’t enough to handle blood sugar ranges for folks with kind 2 diabetes, combining it with insulin remedy is an efficient means to enhance management, as measured by HbA1c.
As a result of folks with kind 1 diabetes don’t produce their very own insulin, insulin remedy is crucial for these with this situation, whereas metformin remedy isn’t.
Nevertheless, as a result of metformin and insulin work in a different way, researchers are exploring metformin’s potential usefulness in folks with kind 1 diabetes.
What occurs when an individual with kind 1 diabetes takes metformin?
In 2017, a meta-analysis revealed within the journal Diabetologia confirmed that greater than 15 p.c of adults with kind 1 diabetes in Scotland had been prescribed metformin. Moreover, in France, metformin has acquired approval for treating each kind 1 and kind 2 diabetes.
The evaluation, entitled “A New Perspective on Metformin Remedy in Kind 1 Diabetes,” notes that, “maybe due to such compelling proof in kind 2 diabetes, off-label use of metformin in kind 1 diabetes is sort of widespread in scientific follow.”
The analysis discovered that individuals with kind 1 diabetes who took metformin along with insulin skilled a big discount within the quantity of insulin they wanted to take every day (a virtually 7-unit-per-day discount) as soon as metformin was added.
Subsequent analysis in 2018 bolstered these findings, exhibiting internet advantages for folks with kind 1 diabetes who added metformin to their present insulin routine. Introducing metformin was once more proven to assist with weight administration and lowering each day insulin wants, and it additionally barely improved blood strain.
Whereas there have been additionally some minor enhancements in common blood sugar ranges, these adjustments weren’t considerably totally different from a bunch taking a placebo (inactive remedy).
Apart from gastrointestinal upset, there have been no critical metformin unintended effects reported from these research.
As famous by Dr. Leon Gussow in Emergency Medication Information, metformin has been having a second within the highlight in recent times attributable to its attainable advantages for bettering cardiovascular well being, lowering irritation, and bettering all-cause mortality (the chance of dying from any trigger).
Dr. Gussow is fast to notice, although, that the proof base right here is in mice and different laboratory animals — not in people.
Nonetheless, off-label use for purported normal well being advantages seems widespread and may probably be particularly useful for folks dwelling with kind 1 diabetes, who’re already at a heightened threat for coronary heart illness, stroke, and untimely dying.
As with all pharmaceuticals, metformin ought to solely be taken below the steerage of a health care provider or different medical skilled, and your medical historical past and well being targets can have a big bearing on whether or not or not a metformin prescription is more likely to be useful.
Continuously requested questions
There may be restricted proof exhibiting that taking metformin might prolong lifespan, however vital scientific trials are underway to be taught extra. One of many largest trials working to ascertain a truth base about metformin’s results on getting old and longevity is called TAME (Concentrating on Getting old with Metformin).
For now, not sufficient is thought to find out the results, if any, of metformin on life expectancy, and that is true for each folks with kind 1 diabetes and with out.
At the least till extra is thought, one of the best guess is to depend on normal steerage out of your physician to enhance your well being and improve your probabilities of a protracted life, together with taking steps equivalent to preserving your blood sugar ranges in vary, consuming a nutritious diet, getting sufficient train, managing stress, and avoiding dangerous behaviors like smoking cigarettes.
Insulin remedy is completely crucial for folks dwelling with kind 1 diabetes to outlive. Metformin, then again, is often thought of to be optionally available for kind 1, and the proof of its advantages for treating this situation isn’t at the moment as sturdy as for the remedy of kind 2 diabetes.
As a result of the pancreas in kind 1 diabetes can’t produce insulin, drugs combining metformin with different glucose-lowering medication are ineffective for this situation.
There are many situations and circumstances that may warrant taking metformin even should you don’t have diabetes. These embrace situations like PCOS (polycystic ovary syndrome) or prediabetes (a situation through which glucose ranges are elevated, however not excessive sufficient to be diabetes).
At present, varied scientific trials are underway to discover whether or not taking metformin each day presents well being advantages to people who’re in any other case wholesome.
Whereas assessments in animals present some enhancements in cardiovascular well being, irritation, and reduces in all-cause mortality, these findings are thus far tentative and haven’t been extensively demonstrated in folks but.
Although metformin is mostly understood to be fairly secure, it’s vital to acknowledge that it does carry some threat of unintended effects.
Metformin could cause upset abdomen, vitamin B12 deficiency, low blood sugar, and really not often — although most significantly — lactic acidosis (a probably deadly buildup of lactic acid within the bloodstream).
For these causes, it’s at all times vital to work together with your physician and medical care crew to know the dangers and advantages of metformin earlier than taking it.
Ultimate ideas
In abstract, metformin, generally used for kind 2 diabetes, can be typically prescribed off-label for kind 1 diabetes, primarily to handle insulin resistance and help with weight administration.
It ought to at all times be used along with insulin remedy for kind 1 diabetes, because it doesn’t exchange the necessity for insulin.
Whereas it could supply advantages equivalent to lowering insulin dosage and aiding weight reduction, it additionally carries potential unintended effects equivalent to gastrointestinal discomfort.
The choice to make use of metformin for kind 1 diabetes must be primarily based on a radical session together with your healthcare supplier, contemplating your medical historical past and well being targets.
