Metformin is essentially the most generally prescribed glucose-lowering medication on the planet, and it’s ceaselessly used as a first-line therapy for sort 2 diabetes.
Though the medication is at the moment solely formally authorised 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.
If that’s the case, you might 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 widespread questions you may need about the usage of metformin in sort 1 diabetes.
Why would somebody with sort 1 diabetes wish to take metformin?
Folks with sort 1 diabetes could also be prescribed metformin off-label (in a means not authorised by the FDA) to assist cut back insulin resistance (a situation during 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 commonest cause persons 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 Capsule Assist You Lose Weight?
Although 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 might help cut back the quantity of insulin folks have to take every day.
For folks with sort 1 diabetes, metformin is at all times used together with 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 you probably have sort 1 diabetes, your pancreas produces both little or no or no insulin.
This hormone is important for survival, so it have to be externally administered (by way of 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 sort 1 diabetes can’t regulate their blood glucose ranges, resulting in severe well being problems. Subsequently, insulin remedy is not only a therapy however a life-sustaining necessity for folks with sort 1 diabetes.
Metformin can considerably assist decrease blood sugar ranges, nevertheless it doesn’t improve or restore the physique’s potential to provide insulin.
It’s essential 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, whereas metformin might help you higher handle your blood sugar ranges, the medication 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 perform in numerous methods to assist decrease blood sugar ranges and could be complementary in sure conditions.
Usually, metformin is a each day, or twice each day, oral remedy that comes within the type of a tablet. There are a lot of manufacturers of metformin, together with quite a lot 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 (underneath the pores and skin) by an insulin pump (or within the case of the ultra-rapid-acting insulin Afrezza, inhaled).
Execs 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 carry down blood sugar ranges sooner than metformin can.
Metformin is assumed to work by reducing the discharge of glucose from the liver and rising insulin sensitivity within the muscular tissues.
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 could be very harmful, and doubtlessly 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.
See extra in: Metformin Dosage Information (Min and Max Doses).
Scientific trials over a few years have established that when metformin alone is just not ample to handle blood sugar ranges for folks with sort 2 diabetes, combining it with insulin remedy is an efficient means 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 needed for these with this situation, whereas metformin remedy is just not.
Nonetheless, as a result of metformin and insulin work otherwise, 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 printed within the journal Diabetologia confirmed that greater than 15 % 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 sort 2 diabetes.
The evaluation, entitled “A New Perspective on Metformin Remedy in Sort 1 Diabetes,” notes that, “maybe due to such compelling proof in sort 2 diabetes, off-label use of metformin in sort 1 diabetes is sort of widespread in medical follow.”
The analysis discovered that folks with sort 1 diabetes who took metformin along with insulin skilled a big discount within the quantity of insulin they wanted to take every day (an almost 7-unit-per-day discount) as soon as metformin was added.
Subsequent analysis in 2018 bolstered these findings, displaying internet 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 reducing each day insulin wants, and it additionally barely improved blood stress.
Whereas there have been additionally some minor enhancements in common blood sugar ranges, these adjustments weren’t considerably completely different from a bunch taking a placebo (inactive therapy).
Apart from gastrointestinal upset, there have been no severe metformin negative 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 as a consequence of its attainable advantages for bettering cardiovascular well being, decreasing irritation, and bettering all-cause mortality (the danger 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 widespread and may doubtlessly be particularly useful for folks dwelling with sort 1 diabetes, who’re already at a heightened danger for coronary heart illness, stroke, and untimely demise.
As with all prescribed drugs, metformin ought to solely be taken underneath the steering of a physician or different medical skilled, and your medical historical past and well being objectives can have a big bearing on whether or not or not a metformin prescription is more likely to be useful.
Often requested questions
Does taking metformin prolong life expectancy for sort 1 diabetes?
There may be restricted proof displaying that taking metformin might prolong lifespan, however important medical trials are underway to study extra. One of many largest trials working to determine a truth base about metformin’s results on ageing and longevity is named TAME (Concentrating on Getting old 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.
Not less than till extra is thought, one of the best guess is to depend on normal steering out of your physician to enhance your well being and improve your probabilities of an extended life, together with taking steps comparable to protecting 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 needed for folks dwelling with sort 1 diabetes to outlive. Metformin, alternatively, is often thought-about to be non-compulsory for sort 1, and the proof of its advantages for treating this situation is just not at the moment 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.
For those who cease taking metformin, the drug will keep in your system for about 4 days, so it’s essential to bear in mind that you will have to regulate your insulin doses if you begin or cease taking the medication.
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 medication be used for folks with sort 1 diabetes?
As a result of the pancreas in sort 1 diabetes can’t produce insulin, drugs combining metformin with different glucose-lowering medication are ineffective for this situation.
Study extra in: Metformin Mixture Medication for Sort 2 Diabetes.
What occurs if I take metformin with out being diabetic?
There are many situations and circumstances that may warrant taking metformin even for those who don’t have diabetes. These embrace situations like PCOS (polycystic ovary syndrome) or prediabetes (a situation during 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 Execs & Cons.
At the moment, numerous medical trials are underway to discover whether or not taking metformin each day provides 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 to date tentative and haven’t been broadly demonstrated in folks but.
Is taking metformin protected when you will have sort 1 diabetes?
Although metformin is mostly understood to be fairly protected, it’s essential to acknowledge that it does carry some danger of negative 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 significantly — lactic acidosis (a doubtlessly deadly buildup of lactic acid within the bloodstream).
For these causes, it’s at all times essential to work together with your physician and medical care crew 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 be typically 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 could supply advantages comparable to decreasing insulin dosage and aiding weight reduction, it additionally carries potential negative effects comparable to gastrointestinal discomfort.
The choice to make use of metformin for sort 1 diabetes must be based mostly on a radical session together with your healthcare supplier, contemplating your medical historical past and well being objectives.
Steered subsequent article: All the pieces You Must Know About Metformin.
