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For decades, doctors have relied on metformin to help people with type 2 diabetes manage their blood sugar. Now, new research suggests the widely prescribed drug may offer benefits beyond blood sugar control.
Researchers at Stanford University found that adults with type 2 diabetes who were taking metformin before catching COVID-19 had a 39% lower risk of dying in the year following their infection than patients taking a different type of diabetes medication.
The findings, published in the journal Diabetes, Obesity and Metabolism, point to potential protective effects that go beyond basic glucose control.
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High blood sugar can weaken immune defenses, according to the Centers for Disease Control and Prevention. Metformin lowers blood sugar and helps the body use insulin more effectively, though it’s unclear whether these effects explain the study’s findings.
A Stanford-led study of 53,332 U.S. adults with type 2 diabetes found that patients taking metformin before catching COVID-19 had a 39% lower risk of dying over the following year than those taking DPP-4 inhibitors. (iStock)
Researchers noted that the drug may help regulate a biological pathway involved in blood pressure and fluid balance that influences the severity of COVID-19. Earlier studies have also indicated that metformin can reduce inflammation and lower viral levels in the body during an active infection.
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To assess the impact on long-term survival, the team analyzed U.S. medical records for 53,332 adults with type 2 diabetes who tested positive for COVID-19 between October 2021 and November 2023.
All patients were between 30 and 85 years old and had been prescribed either metformin or another diabetes drug, known as dipeptidyl peptidase-4 inhibitor (DPP4i), at least a month before their diagnosis.
An independent epidemiologist noted that patients on metformin are generally healthier and younger than those prescribed DPP-4 inhibitors, which are typically reserved for older patients or those with kidney disease. (iStock)
“Metformin is the first drug most people with type 2 diabetes are given. DPP-4 inhibitors usually come later, or go to people who cannot take metformin, often because they are older or have kidney disease or other health problems,” Ziyad Al-Aly, M.D., a senior clinical epidemiologist at Washington University in St. Louis, told Fox News Digital.
“Put simply, people on metformin are generally healthier than people on DPP-4 inhibitors,” added Al-Aly, who was not involved in the study.
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Most of the group, 50,965 patients, were taking metformin, while 2,367 were taking a DPP4i. Patients on metformin were slightly younger on average, 60 years old compared with 64 for those on the alternative medication.
After adjusting for age, gender and other variables, the researchers found that patients taking metformin were more likely to survive over the following year.
The data initially suggested a 13% drop in long COVID symptoms among metformin users, though further statistical testing found no statistically significant link. (iStock)
The data initially suggested a 13% drop in long COVID symptoms among metformin users, though further statistical testing found no statistically significant link.
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The new analysis aligns with other recent research, including a study from the University of Minnesota Medical School that showed patients who were prescribed metformin within six days of a COVID-19 diagnosis were less likely to die or develop long COVID.
“There is some evidence from the same group that metformin, started early in a COVID infection, may lower the risk of long COVID, [but] that still needs to be confirmed in large, well-designed randomized trials,” Al-Aly noted.
Both the study authors and an outside expert emphasized that more clinical trials are needed, and advised diabetes patients not to alter their current medications based on these findings. (iStock)
Because the Stanford review relied on existing medical records rather than a clinical trial, the authors cautioned that the study cannot prove metformin directly caused the higher survival rate.
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Patients taking DPP4i medications tended to be older and had more underlying health conditions, which could have contributed to their higher mortality risk, the researchers noted.
The team also lacked complete records on patients’ COVID-19 vaccination status.
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“This is not enough evidence to change treatment,” Al-Aly cautioned. “People take a DPP-4 inhibitor because they need it to control their diabetes, usually because metformin was not enough or was not an option for them.”
“No doctor is choosing between these two drugs for the same patient. The comparison in this study is not a real choice in any clinic. If you take either drug, do not change it because of this study.”