Metformin is probably the most generally prescribed glucose-lowering drugs on this planet, and it’s steadily used as a first-line remedy for sort 2 diabetes.
Though the medication is presently solely formally permitted by the U.S. Meals and Drug Administration (FDA) for treating sort 2 diabetes, you could have heard about folks with sort 1 diabetes being prescribed metformin off-label.
In that case, you could 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 means not permitted by the FDA) to assist scale 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 on account 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 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 Tablet 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 will help scale back the quantity of insulin folks must take every day.
For folks with sort 1 diabetes, metformin is all the time used at the side of insulin remedy.
Can metformin exchange insulin?
It’s not protected for folks with insulin-dependent diabetes to aim to exchange insulin with metformin.
Administration of sort 1 diabetes requires insulin remedy. It is because in case you have sort 1 diabetes, your pancreas produces both little or no or no insulin.
This hormone is crucial 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 power.
With out insulin remedy, folks with sort 1 diabetes can not regulate their blood glucose ranges, resulting in severe well being problems. Due to this fact, insulin remedy isn’t just a remedy however a life-sustaining necessity for folks with sort 1 diabetes.
Metformin can considerably assist decrease blood sugar ranges, but it surely doesn’t enhance or restore the physique’s means to provide insulin.
It’s vital to seek the advice of along with your physician about medicines you’re taking to ensure your prescriptions and plan of care are updated and to assist stop unintended interactions.
However both means, whereas metformin will 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. Relatively, they perform in numerous methods to assist decrease blood sugar ranges and will be complementary in sure conditions.
Normally, metformin is a day by day, or twice day by day, oral treatment that comes within the type of a tablet. There are various 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 (underneath 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 power. As a common matter, insulin helps to deliver down blood sugar ranges quicker than metformin can.
Metformin is assumed to work by reducing the discharge of glucose from the liver and growing insulin sensitivity within the muscle tissues.
Regardless of their advantages, as with all medicines, there are additionally downsides to each metformin and insulin.
Insulin is a robust 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 just too massive 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 isn’t adequate 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 crucial for these with this situation, whereas metformin remedy isn’t.
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 acquired 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 sort of frequent in scientific observe.”
The analysis discovered that individuals 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 strengthened 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 day by 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 completely different from a bunch taking a placebo (inactive remedy).
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 attributable to its doable advantages for bettering cardiovascular well being, decreasing irritation, and bettering all-cause mortality (the danger 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 common well being advantages seems frequent and might probably be particularly useful for folks residing with sort 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 underneath the steerage of a health care provider or different medical skilled, and your medical historical past and well being targets could have a big bearing on whether or not or not a metformin prescription is more likely to be useful.
Ceaselessly requested questions
Does taking metformin lengthen life expectancy for sort 1 diabetes?
There may be restricted proof displaying that taking metformin might lengthen lifespan, however vital scientific trials are underway to study extra. One of many largest trials working to determine a reality base about metformin’s results on getting older and longevity is named TAME (Focusing 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 sort 1 diabetes and with out.
Not less than till extra is thought, one of the best guess is to depend on common steerage out of your physician to enhance your well being and enhance your probabilities of an extended life, together with taking steps resembling retaining 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 residing with sort 1 diabetes to outlive. Metformin, alternatively, is often thought-about to be elective for sort 1, and the proof of its advantages for treating this situation isn’t presently as sturdy as for the remedy 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 usually 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.
When you cease taking metformin, the drug will keep in your system for about 4 days, so it’s vital to remember that you could 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 medicine be used for folks with sort 1 diabetes?
As a result of the pancreas in sort 1 diabetes can not produce insulin, medicines 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 situations and circumstances which may warrant taking metformin even when you 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 Professionals & Cons.
Presently, numerous scientific trials are underway to discover whether or not taking metformin day by day presents 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 to date tentative and haven’t been extensively demonstrated in folks but.
Is taking metformin protected when you’ve gotten sort 1 diabetes?
Although metformin is usually understood to be fairly protected, it’s vital to acknowledge that it does carry some threat 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 critically — lactic acidosis (a probably deadly buildup of lactic acid within the bloodstream).
For these causes, it’s all the time vital to work along with your physician and medical care staff to grasp the dangers and advantages of metformin earlier than taking it.
Study extra in: Is Metformin Secure?
Remaining ideas
In abstract, metformin, generally used for sort 2 diabetes, can also be typically prescribed off-label for sort 1 diabetes, primarily to handle insulin resistance and help with weight administration.
It ought to all the time be used along with insulin remedy for sort 1 diabetes, because it doesn’t exchange the necessity for insulin.
Whereas it could provide advantages resembling decreasing insulin dosage and aiding weight reduction, it additionally carries potential negative effects resembling gastrointestinal discomfort.
The choice to make use of metformin for sort 1 diabetes must be based mostly on a radical session along with your healthcare supplier, contemplating your medical historical past and well being targets.
Steered subsequent article: The whole lot You Have to Know About Metformin.
