Metformin is the mostly prescribed glucose-lowering medication on the planet, and it’s ceaselessly used as a first-line remedy for sort 2 diabetes.
Though the medication is at the moment solely formally permitted by the U.S. Meals and Drug Administration (FDA) for treating sort 2 diabetes, you could have heard about individuals with sort 1 diabetes being prescribed metformin off-label.
In that case, you could be questioning whether or not individuals with sort 1 diabetes can take metformin, whether or not this association is secure, and the way metformin works for individuals with sort 1.
This text will examine using metformin for sort 1 diabetes and reply some widespread questions you may need about using metformin in sort 1 diabetes.
Desk of Contents
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 permitted by the FDA) to assist scale back insulin resistance (a situation by 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 individuals 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.
Study extra in: Metformin and Weight Loss: Can a Capsule 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 present 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 at the side of insulin remedy.
“Again in 2017, I seen my blood glucose management and A1c plateauing, principally on account of insulin resistance. My physician advisable that I begin taking metformin to assist enhance my diabetes administration.”
Kat Schroeder, T1D (examine Kat’s expertise with metformin)
Can metformin change insulin?
It’s not secure for individuals with insulin-dependent diabetes to aim to switch insulin with metformin.
Administration of sort 1 diabetes requires insulin remedy. It’s 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, individuals with sort 1 diabetes can’t regulate their blood glucose ranges, resulting in critical well being problems. Subsequently, insulin remedy is not only 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 improve or restore the physique’s skill to provide insulin.
It’s essential to seek the advice of together with your physician about medicines you’re taking to verify 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. Reasonably, they perform in numerous methods to assist decrease blood sugar ranges and might be complementary in sure conditions.
On the whole, metformin is a day by day, or twice day by day, oral medicine that comes within the type of a tablet. There are lots 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 (below 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 a necessary hormone that helps sugar from the blood enter the physique’s cells for use as power. As a normal matter, insulin helps to deliver down blood sugar ranges sooner than metformin can.
Metformin is believed to work by lowering the discharge of glucose from the liver and rising insulin sensitivity within the muscle mass.
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 may cause low blood sugar (hypoglycemia), which might be very harmful, and doubtlessly deadly, if untreated.
Metformin may cause abdomen discomfort, diarrhea, and different digestive points, particularly if the dose is just 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 shouldn’t be ample to handle blood sugar ranges for individuals with sort 2 diabetes, combining it with insulin remedy is an efficient means 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 needed for these with this situation, whereas metformin remedy shouldn’t be.
Nonetheless, as a result of metformin and insulin work in a different way, 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 % 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 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 widespread in scientific apply.”
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 (a virtually 7-unit-per-day discount) as soon as metformin was added.
Subsequent analysis in 2018 bolstered these findings, exhibiting web advantages for individuals with sort 1 diabetes who added metformin to their present insulin routine. Introducing metformin was once more proven to assist with weight administration and lowering 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 modifications weren’t considerably totally different from a gaggle taking a placebo (inactive remedy).
Apart from gastrointestinal upset, there have been no critical metformin unwanted side effects reported from these research.
As famous by Dr. Leon Gussow in Emergency Drugs Information, metformin has been having a second within the highlight in recent times on account of its potential 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 widespread and may doubtlessly be particularly useful for individuals residing 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 below the steering of a health care provider or different medical skilled, and your medical historical past and well being objectives could have a major bearing on whether or not or not a metformin prescription is prone to be useful.
Continuously 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 scientific trials are underway to study extra. One of many largest trials working to ascertain a reality base about metformin’s results on growing older and longevity is called TAME (Focusing on Getting older with Metformin).
For now, not sufficient is understood to find out the results, if any, of metformin on life expectancy, and that is true for each individuals with sort 1 diabetes and with out.
At the very least till extra is understood, the very best wager is to depend on normal steering out of your physician to enhance your well being and improve your probabilities of a protracted life, together with taking steps akin to preserving 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 typically?
Insulin remedy is totally needed for individuals residing with sort 1 diabetes to outlive. Metformin, however, is often thought of to be non-obligatory for sort 1, and the proof of its advantages for treating this situation shouldn’t be at the moment as robust 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 typically 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 will by no means see any impact in any respect.
In the event you cease taking metformin, the drug will keep in your system for about 4 days, so it’s essential to bear in mind 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 medication be used for individuals with sort 1 diabetes?
As a result of the pancreas in sort 1 diabetes can’t produce insulin, medicines combining metformin with different glucose-lowering medication are ineffective for this situation.
Study extra in: Metformin Mixture Medicine for Kind 2 Diabetes.
What occurs if I take metformin with out being diabetic?
There are many circumstances and circumstances that may warrant taking metformin even if you happen to don’t have diabetes. These embody circumstances like PCOS (polycystic ovary syndrome) or prediabetes (a situation by 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, varied scientific trials are underway to discover whether or not taking metformin day by day affords 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 up to now tentative and haven’t been extensively demonstrated in individuals but.
Is taking metformin secure when you’ve got sort 1 diabetes?
Although metformin is mostly understood to be fairly secure, it’s essential to acknowledge that it does carry some danger of unwanted side effects.
See extra in: Metformin Facet Results (Frequent and Critical).
Metformin may cause upset abdomen, vitamin B12 deficiency, low blood sugar, and really hardly ever — although most significantly — lactic acidosis (a doubtlessly deadly buildup of lactic acid within the bloodstream).
For these causes, it’s all the time essential to work together with your physician and medical care staff to grasp the dangers and advantages of metformin earlier than taking it.
Study extra in: Is Metformin Protected?
Closing 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 change the necessity for insulin.
Whereas it might provide advantages akin to lowering insulin dosage and aiding weight reduction, it additionally carries potential unwanted side effects akin to gastrointestinal discomfort.
The choice to make use of metformin for sort 1 diabetes needs to be based mostly on a radical session together with your healthcare supplier, contemplating your medical historical past and well being objectives.
Urged subsequent article: All the pieces You Must Know About Metformin.