Risks and benefits of the first line treatment for diabetes with metformin

Although the drug metformin is considered the gold standard in the management of type 2 diabetes, a study by a group of French researchers published in this week's PLoS Medicine suggests that the long-term benefits of this drug compared with the risks are not clearly established - an important finding given that currently, thousands of people around the world are regularly taking metformin to help control their blood sugar levels in the belief that it also has long-lasting health benefits.

For the past 14 years, metformin – the active ingredient of Merck KGaA’s now off-patent Glucophage brand - has been recommended as the first-line treatment for type 2 diabetes after a landmark study (the UK Prospective Diabetes Study) reported that when combined with dietary control measures, metformin reduced death from all causes in overweight people with type 2 diabetes. However, an overlooked finding from this study was that in non-overweight people with type 2 diabetes, metformin may actually increase the risk of death.

In this new analysis, the authors led by Catherine Cornu from the Clinical Investigation Centre, in Lyon, France, analysed the data available from all relevant studies to re-evaluate the balance of the benefits versus the risks of taking metformin for type 2 diabetes.