Metformin, a drug used as a first-line treatment for type 2 diabetes, has been associated with a 30% lower risk of death, according to a new study. The research adds to the growing body of evidence suggesting that the common drug may possess anti-aging properties.
For decades, the drug metformin has been a first-line treatment for type 2 diabetics who can’t control their blood sugar through diet and exercise alone. In recent years, research has shown that the drug’s health-promoting properties extend beyond diabetes, including decreasing dementia risk and reducing osteoarthritic knee pain.
Now, a new study led by the University of California, San Diego (UC San Diego) has found that metformin use by women with type 2 diabetes was associated with “exceptional longevity,” which is defined as living to advanced ages such as 90 and older.
Metformin is known to activate FOXO3, a gene that has been strongly implicated in aging processes and longevity. It’s involved in regulating the cellular response to stress, such as oxidative stress, a key factor in aging. It activates genes that enhance cell survival and resistance to programmed cell death or apoptosis. And it’s involved in the regulation of DNA repair mechanisms.
However, studies on the association between metformin and lifespan in mice and humans have produced mixed results thus far. While these previous studies have primarily been focused on the association between metformin and mortality or disease, no observational studies or randomized controlled trials (RCTs) have looked at whether metformin increases exceptional longevity. So, that’s what the researchers examined in the present study by adopting a research method known as the “target trial emulation framework,” which mimics the design of an RCT when an actual RCT is not feasible.
They obtained data from the Women’s Health Initiative (WHI) study on 438 postmenopausal women newly diagnosed with type 2 diabetes and started on anti-diabetic medication. The WHI followed a large US cohort for over 30 years, from midlife to age 90 and older. The researchers specifically compared women taking metformin alone with those only taking another class of blood glucose-lowering medication called sulfonylurea. They made sure that the two groups were as similar as possible in terms of age, lifestyle, health conditions, and other factors to ensure a fair comparison.
The study’s key finding was that those women who started metformin had a 30% lower rate of dying before age 90 than those who started sulfonylurea. The finding suggested that commencing metformin after a diagnosis of type 2 diabetes was associated with a better chance of living longer, compared to commencing sulfonylurea.
“In this first target trial emulation of metformin and exceptional longevity, we found that metformin initiation increased exceptional longevity compared with sulfonylurea initiation among women with type 2 diabetes,” the researchers said.
The study’s most significant limitations included only using women, not including a non-diabetic comparison group, and not including a comparison group taking a placebo, which would normally be included in an RCT. Indeed, it is because of these limitations that the researchers advise interpreting their findings with caution. They also stress that the findings cannot establish causation and that future studies are needed to determine the underlying cause of the relationship between metformin and longevity.
The study was published in the Journal of Gerontology: Medical Sciences.
Source: UC San Diego
