Metformin: Two for the Price of One?

In 4 days, the competitive shopping event known as Black Friday will descend upon us.  That's the day when retailers beguile us with tempting offers in hopes that we'll buy more while we're there, having valiantly fought off the other shoppers.  Short of being given something for free, BOGO (buy one, get one) is the next best thing.  Just over a week ago, I commented on a study suggesting that statin use lowered the risk of cancer death.  So if you need to take a statin (having failed all lifestyle attempts at lowering one's cholesterol), isn't it nice to know that you might also be lowering your risk of death from cancer?

With that in mind, I thought I'd point out a retrospective cohort study published earlier this month in Annals of Internal Medicine, in which the authors concluded that use of sulfonylureas to lower blood sugar in diabetics was associated with an increase risk of heart disease deaths compared to use of metformin.  I'll be the first to admit that given a choice, I like to use metformin if intense lifestyle modifications aren't enough to deal with one's diabetes, mainly because the biguanide doesn't cause hypoglycemia, which can be a real problem in the elderly.  And now a study suggests this same drug is less likely to cause heart disease death.  Woo hoo!

So go talk to your family doc or endocrinologist and see if metformin is right for you.  And do you really need a sulfonylurea?  Just know that if you have kidney problems, you probably shouldn't be using the biguanide, metformin, as it can cause lactic acidosis.  But aside from that point, it's a very safe & easy to use medication.  And do remember that what you eat and your level of physical activity are paramount in controlling your sugars.

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