Metformin is the mostly prescribed glucose-lowering medication on this planet, and it’s incessantly used as a first-line therapy for sort 2 diabetes.
Though the drugs is presently solely formally authorised by the U.S. Meals and Drug Administration (FDA) for treating sort 2 diabetes, you might have heard about individuals with sort 1 diabetes being prescribed metformin off-label.
If that’s the 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 the usage of metformin for sort 1 diabetes and reply some widespread questions you might need about the usage of metformin in sort 1 diabetes.
Desk of Contents
Why would somebody with sort 1 diabetes need to take metformin?
Folks with sort 1 diabetes could also be prescribed metformin off-label (in a manner not authorised by the FDA) to assist cut 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 (normally because 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 motive persons are prescribed metformin, the drug is understood to scale back urge for food and assist the physique be barely extra metabolically environment friendly, which may result in weight reduction over time.
Study extra in: Metformin and Weight Loss: Can a Capsule 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 individuals with sort 1 diabetes who begin taking metformin, analysis has discovered that including metformin to an present insulin routine might help cut back the quantity of insulin individuals have to take every day.
For individuals with sort 1 diabetes, metformin is at all times used at the side of insulin remedy.
“Again in 2017, I seen my blood glucose management and A1c plateauing, principally attributable to insulin resistance. My physician really helpful 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 interchange insulin with metformin.
Administration of sort 1 diabetes requires insulin remedy. It’s because if 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 should be externally administered (by way of injection or infusion) to keep up 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 therapy however a life-sustaining necessity for individuals with sort 1 diabetes.
Metformin can considerably assist decrease blood sugar ranges, but it surely doesn’t enhance or restore the physique’s potential to supply insulin.
It’s necessary to seek the advice of along 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 manner, whereas metformin might help you higher handle your blood sugar ranges, the drugs can by no means function a substitute 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.
On the whole, metformin is a each day, or twice each day, oral medicine that comes within the type of a capsule. There are numerous manufacturers of metformin, together with quite a lot 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).
Execs 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 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 tissue.
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 will be very harmful, and doubtlessly deadly, if untreated.
Metformin may 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 shouldn’t be enough to handle blood sugar ranges for individuals with sort 2 diabetes, combining it with insulin remedy is an efficient manner 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 obligatory 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 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 widespread in scientific follow.”
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 present insulin routine. Introducing metformin was once more proven to assist with weight administration and reducing each 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 totally different from a gaggle taking a placebo (inactive therapy).
Apart from gastrointestinal upset, there have been no severe metformin unwanted side 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 potential advantages for enhancing cardiovascular well being, decreasing irritation, and enhancing all-cause mortality (the chance 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 widespread and may doubtlessly be particularly useful for individuals 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 below the steerage of a physician or different medical skilled, and your medical historical past and well being targets could have a major bearing on whether or not or not a metformin prescription is more likely to be useful.
Incessantly requested questions
Does taking metformin lengthen life expectancy for sort 1 diabetes?
There’s restricted proof exhibiting that taking metformin might lengthen lifespan, however important scientific 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 called TAME (Concentrating on Ageing 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.
Not less than till extra is understood, the most effective 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 similar to conserving 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 obligatory for individuals residing with sort 1 diabetes to outlive. Metformin, then again, is normally thought-about to be elective for sort 1, and the proof of its advantages for treating this situation shouldn’t be presently as sturdy as for the therapy 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 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.
If you happen to cease taking metformin, the drug will keep in your system for about 4 days, so it’s necessary to remember that you might 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, medicines combining metformin with different glucose-lowering medication 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 that may warrant taking metformin even should you don’t have diabetes. These embody situations 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 Execs & Cons.
Presently, varied scientific 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 assessments 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 individuals but.
Is taking metformin secure when you’ve sort 1 diabetes?
Although metformin is mostly understood to be fairly secure, it’s necessary to acknowledge that it does carry some threat of unwanted side effects.
See extra in: Metformin Facet Results (Widespread and Severe).
Metformin may cause upset abdomen, vitamin B12 deficiency, low blood sugar, and really hardly ever — although most severely — lactic acidosis (a doubtlessly deadly buildup of lactic acid within the bloodstream).
For these causes, it’s at all times necessary to work along with your physician and medical care staff to know the dangers and advantages of metformin earlier than taking it.
Study extra in: Is Metformin Secure?
Last 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 at all times be used along with insulin remedy for sort 1 diabetes, because it doesn’t change the necessity for insulin.
Whereas it could provide advantages similar to decreasing insulin dosage and aiding weight reduction, it additionally carries potential unwanted side effects similar to gastrointestinal discomfort.
The choice to make use of metformin for sort 1 diabetes must be based mostly on an intensive session along with your healthcare supplier, contemplating your medical historical past and well being targets.
Recommended subsequent article: All the pieces You Have to Know About Metformin.
