Metformin is essentially the most generally prescribed glucose-lowering medication on this planet, and it’s steadily used as a first-line therapy for sort 2 diabetes.
Though the drugs is presently solely formally authorized by the U.S. Meals and Drug Administration (FDA) for treating sort 2 diabetes, you will have heard about folks with sort 1 diabetes being prescribed metformin off-label.
In that case, it’s possible you’ll be questioning whether or not folks with sort 1 diabetes can take metformin, whether or not this association is protected, and the way metformin works for folks with sort 1.
This text will examine the usage of metformin for sort 1 diabetes and reply some frequent questions you may need about the usage of metformin in sort 1 diabetes.
Why would somebody with sort 1 diabetes need to take metformin?
Individuals with sort 1 diabetes could also be prescribed metformin off-label (in a manner not authorized by the FDA) to assist scale back insulin resistance (a situation by 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 medical trials and meta-analyses have proven that taking metformin can result in modest weight reduction. Though this isn’t the most typical purpose individuals are prescribed metformin, the drug is thought to scale back urge for food and assist the physique be barely extra metabolically environment friendly, which might result in weight reduction over time.
Study extra in: Metformin and Weight Loss: Can a Tablet Assist You Lose Weight?
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 sort 1 diabetes who begin taking metformin, analysis has discovered that including metformin to an current insulin routine can assist scale back the quantity of insulin folks must take every day.
For folks with sort 1 diabetes, metformin is at all times used at the side of insulin remedy.
Can metformin change insulin?
It’s not protected for folks with insulin-dependent diabetes to aim to interchange insulin with metformin.
Administration of sort 1 diabetes requires insulin remedy. It’s because when you’ve got sort 1 diabetes, your pancreas produces both little or no or no insulin.
This hormone is essential for survival, so it should be externally administered (by way of injection or infusion) to keep up regular blood sugar ranges and make sure the physique’s cells obtain the glucose they want for vitality.
With out insulin remedy, folks with sort 1 diabetes can not regulate their blood glucose ranges, resulting in critical well being issues. Due to this fact, insulin remedy isn’t just a therapy however a life-sustaining necessity for folks with sort 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 along with your physician about drugs you’re taking to verify your prescriptions and plan of care are updated and to assist forestall unintended interactions.
However both manner, whereas metformin can assist you higher handle your blood sugar ranges, the drugs can by no means function a alternative for insulin.
Is taking insulin higher than taking metformin?
Neither insulin nor metformin is superior to the opposite. Quite, they operate in numerous methods to assist decrease blood sugar ranges and may be complementary in sure conditions.
Usually, metformin is a each day, or twice each day, oral treatment that comes within the type of a tablet. There are numerous manufacturers of metformin, together with quite a lot of mixture medicine 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 an important hormone that helps sugar from the blood enter the physique’s cells for use as vitality. As a normal matter, insulin helps to convey down blood sugar ranges sooner than metformin can.
Metformin is believed to work by lowering the discharge of glucose from the liver and growing insulin sensitivity within the muscle tissue.
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 may 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 massive or whether it is taken on an empty abdomen.
See extra in: Metformin Dosage Information (Min and Max Doses).
Medical trials over a few years have established that when metformin alone will not be adequate to handle blood sugar ranges for folks with sort 2 diabetes, combining it with insulin remedy is an efficient manner to enhance management, as measured by HbA1c.
As a result of folks with sort 1 diabetes don’t produce their very own insulin, insulin remedy is crucial for these with this situation, whereas metformin remedy will not be.
Nevertheless, as a result of metformin and insulin work in a different way, researchers are exploring metformin’s potential usefulness in folks with sort 1 diabetes.
What occurs when an individual with sort 1 diabetes takes metformin?
In 2017, a meta-analysis revealed within the journal Diabetologia confirmed that greater than 15 p.c of adults with sort 1 diabetes in Scotland had been prescribed metformin. Moreover, in France, metformin has obtained approval for treating each sort 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 sort 2 diabetes, off-label use of metformin in sort 1 diabetes is kind of frequent in medical follow.”
The analysis discovered that folks with sort 1 diabetes who took metformin along with insulin skilled a major 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, displaying web advantages for folks with sort 1 diabetes who added metformin to their current 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 modifications weren’t considerably completely different from a bunch taking a placebo (inactive therapy).
Apart from gastrointestinal upset, there have been no critical metformin unwanted effects reported from these research.
As famous by Dr. Leon Gussow in Emergency Drugs Information, metformin has been having a second within the highlight lately on account of its potential advantages for enhancing cardiovascular well being, lowering irritation, and enhancing all-cause mortality (the chance of demise 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 frequent and might probably be particularly useful for folks dwelling with sort 1 diabetes, who’re already at a heightened threat for coronary heart illness, stroke, and untimely demise.
As with all prescribed drugs, metformin ought to solely be taken below the steering of a health care provider or different medical skilled, and your medical historical past and well being objectives can have a major bearing on whether or not or not a metformin prescription is prone to be useful.
Incessantly requested questions
Does taking metformin prolong life expectancy for sort 1 diabetes?
There may be restricted proof displaying that taking metformin could prolong lifespan, however important medical trials are underway to study extra. One of many largest trials working to ascertain a truth base about metformin’s results on growing old and longevity is called TAME (Concentrating on Growing older with Metformin).
For now, not sufficient is thought to find out the consequences, if any, of metformin on life expectancy, and that is true for each folks with sort 1 diabetes and with out.
At the very least till extra is thought, one of the best wager is to depend on normal steering out of your physician to enhance your well being and improve your possibilities of a protracted life, together with taking steps corresponding to maintaining your blood sugar ranges in vary, consuming a nutritious diet, getting sufficient train, managing stress, and avoiding dangerous behaviors like smoking cigarettes.
Why is metformin not used for sort 1 diabetes extra usually?
Insulin remedy is completely crucial for folks dwelling with sort 1 diabetes to outlive. Metformin, however, is often thought of to be non-obligatory for sort 1, and the proof of its advantages for treating this situation will not be presently as robust as for the therapy of sort 2 diabetes.
Does metformin decrease blood sugar instantly?
No — in contrast to insulin, which begins to decrease blood sugar in a short time, metformin typically takes 2 to five days to decrease common blood sugar ranges.
Some folks is not going to discover results from metformin for so long as 2 weeks after beginning the drug, and a few won’t ever see any impact in any respect.
In case you cease taking metformin, the drug will keep in your system for about 4 days, so it’s vital to remember that you will have to regulate your insulin doses while you begin or cease taking the drugs.
Learn extra in: Stopping Metformin: When and How You Can Cease Taking Metformin and How Lengthy Does Metformin Keep In Your System?
Can metformin mixture medicine be used for folks with sort 1 diabetes?
As a result of the pancreas in sort 1 diabetes can not produce insulin, drugs combining metformin with different glucose-lowering medicine are ineffective for this situation.
Study extra in: Metformin Mixture Medication for Kind 2 Diabetes.
What occurs if I take metformin with out being diabetic?
There are many circumstances and circumstances which may warrant taking metformin even should you don’t have diabetes. These embrace circumstances like PCOS (polycystic ovary syndrome) or prediabetes (a situation by which glucose ranges are elevated, however not excessive sufficient to be diabetes).
Learn extra in: Metformin for PCOS (Advantages and Facet Results) and Metformin for Prediabetes: The Professionals & Cons.
At present, numerous medical trials are underway to discover whether or not taking metformin each day gives well being advantages to people who’re in any other case wholesome.
Whereas checks in animals present some enhancements in cardiovascular well being, irritation, and reduces in all-cause mortality, these findings are up to now tentative and haven’t been extensively demonstrated in folks but.
Is taking metformin protected when you’ve got sort 1 diabetes?
Although metformin is usually understood to be fairly protected, it’s vital to acknowledge that it does carry some threat of unwanted effects.
See extra in: Metformin Facet Results (Frequent and Severe).
Metformin could cause upset abdomen, vitamin B12 deficiency, low blood sugar, and really not often — although most critically — lactic acidosis (a probably deadly buildup of lactic acid within the bloodstream).
For these causes, it’s at all times vital to work along with your physician and medical care workforce to grasp the dangers and advantages of metformin earlier than taking it.
Study extra in: Is Metformin Protected?
Remaining ideas
In abstract, metformin, generally used for sort 2 diabetes, can also be generally prescribed off-label for sort 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 sort 1 diabetes, because it doesn’t change the necessity for insulin.
Whereas it might supply advantages corresponding to lowering insulin dosage and aiding weight reduction, it additionally carries potential unwanted effects corresponding to gastrointestinal discomfort.
The choice to make use of metformin for sort 1 diabetes ought to be based mostly on an intensive session along with your healthcare supplier, contemplating your medical historical past and well being objectives.
Instructed subsequent article: Every part You Have to Know About Metformin.
