Metformin is probably the most generally prescribed glucose-lowering medication on this planet, and it’s regularly used as a first-line remedy for sort 2 diabetes.
Though the drugs is presently solely formally accredited by the U.S. Meals and Drug Administration (FDA) for treating sort 2 diabetes, you will have heard about individuals with sort 1 diabetes being prescribed metformin off-label.
If that’s the case, it’s possible you’ll be questioning whether or not individuals with sort 1 diabetes can take metformin, whether or not this association is protected, and the way metformin works for individuals with sort 1.
This text will examine using metformin for sort 1 diabetes and reply some frequent questions you may need about using metformin in sort 1 diabetes.
Why would somebody with sort 1 diabetes wish to take metformin?
Individuals with sort 1 diabetes could also be prescribed metformin off-label (in a method not accredited 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 instances for weight reduction (normally 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 persons are prescribed metformin, the drug is understood to cut back urge for food and assist the physique be barely extra metabolically environment friendly, which might result in weight reduction over time.
Be taught 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 individuals 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 individuals have to take every day.
For individuals with sort 1 diabetes, metformin is all the time used along with insulin remedy.
Can metformin change insulin?
It’s not protected for individuals 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 essential for survival, so it should 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, individuals with sort 1 diabetes can’t regulate their blood glucose ranges, resulting in severe well being problems. Subsequently, insulin remedy isn’t just a remedy however a life-sustaining necessity for individuals with sort 1 diabetes.
Metformin can considerably assist decrease blood sugar ranges, however it doesn’t enhance or restore the physique’s potential to supply insulin.
It’s vital to seek the advice of along with your physician about drugs you’re taking to ensure your prescriptions and plan of care are updated and to assist forestall unintended interactions.
However both method, whereas metformin will help 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. Reasonably, they perform in several methods to assist decrease blood sugar ranges and could be complementary in sure conditions.
Generally, metformin is a each day, or twice each day, oral treatment that comes within the type of a capsule. There are a lot of manufacturers of metformin, together with a wide range of mixture medication that embody metformin as one of many therapies.
There are additionally many sorts of insulin, that are both injected or administered subcutaneously (beneath 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 quicker than metformin can.
Metformin is believed to work by lowering the discharge of glucose from the liver and growing 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 robust hormone, and taking an excessive amount of could cause low blood sugar (hypoglycemia), which could 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).
Scientific trials over a few years have established that when metformin alone will not be enough to handle blood sugar ranges for individuals with sort 2 diabetes, combining it with insulin remedy is an efficient method to enhance management, as measured by HbA1c.
As a result of individuals with sort 1 diabetes don’t produce their very own insulin, insulin remedy is mandatory for these with this situation, whereas metformin remedy will not be.
Nevertheless, as a result of metformin and insulin work otherwise, researchers are exploring metformin’s potential usefulness in individuals 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 sort of frequent in medical observe.”
The analysis discovered that individuals 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 (an almost 7-unit-per-day discount) as soon as metformin was added.
Subsequent analysis in 2018 strengthened these findings, exhibiting web advantages for individuals 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 stress.
Whereas there have been additionally some minor enhancements in common blood sugar ranges, these adjustments weren’t considerably totally different from a gaggle taking a placebo (inactive remedy).
Apart from gastrointestinal upset, there have been no severe 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 lately resulting from its attainable advantages for enhancing cardiovascular well being, lowering irritation, and enhancing 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 frequent and might probably be particularly useful for individuals dwelling with sort 1 diabetes, who’re already at a heightened danger for coronary heart illness, stroke, and untimely demise.
As with all pharmaceuticals, metformin ought to solely be taken beneath the steering of a physician or different medical skilled, and your medical historical past and well being targets may 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’s restricted proof exhibiting that taking metformin could prolong lifespan, however important medical trials are underway to study extra. One of many largest trials working to determine a reality base about metformin’s results on growing old and longevity is named TAME (Focusing on Getting older with Metformin).
For now, not sufficient is understood to find out the consequences, if any, of metformin on life expectancy, and that is true for each individuals with sort 1 diabetes and with out.
Not less than till extra is understood, the perfect guess is to depend on normal steering out of your physician to enhance your well being and enhance your possibilities of an extended life, together with taking steps similar to holding 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 mandatory for individuals dwelling with sort 1 diabetes to outlive. Metformin, however, is normally thought-about to be optionally available for sort 1, and the proof of its advantages for treating this situation will not be presently as robust as for the remedy of sort 2 diabetes.
Does metformin decrease blood sugar instantly?
No — not like 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 individuals won’t 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.
If you happen to 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 once 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 medication be used for individuals 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.
Be taught 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 that may warrant taking metformin even for those who don’t have diabetes. These embody 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.
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 checks 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 individuals but.
Is taking metformin protected when you’ve got sort 1 diabetes?
Although metformin is mostly understood to be fairly protected, it’s vital to acknowledge that it does carry some danger of unintended effects.
See extra in: Metformin Facet Results (Widespread and Critical).
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 all the time vital to work along with your physician and medical care crew to know the dangers and advantages of metformin earlier than taking it.
Be taught extra in: Is Metformin Secure?
Last ideas
In abstract, metformin, generally used for sort 2 diabetes, can be generally 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 change the necessity for insulin.
Whereas it might supply advantages similar to lowering insulin dosage and aiding weight reduction, it additionally carries potential unintended effects similar to gastrointestinal discomfort.
The choice to make use of metformin for sort 1 diabetes needs to be primarily based on an intensive session along with your healthcare supplier, contemplating your medical historical past and well being targets.
Instructed subsequent article: All the pieces You Have to Know About Metformin.
