Metformin
Status
FDA-approved. FDA-approved labeling exists as an adjunct to diet and exercise to improve glycaemic control in adults and children with type 2 diabetes. It carries a boxed warning for lactic acidosis. There is no approved indication for ageing, longevity or weight loss.
What it is
A first-line diabetes medicine also studied for aging outcomes.
What published research measured
A biguanide and one of the most prescribed medicines in the world, with a randomized base in type 2 diabetes going back to the UK Prospective Diabetes Study, which reported reduced diabetes-related endpoints and mortality in overweight patients. Its longevity reputation rests largely on observational analyses suggesting diabetic patients on metformin outlived matched non-diabetic controls, a finding with well-described confounding problems that has not been confirmed prospectively. The TAME trial designed to test the ageing hypothesis directly has faced funding difficulty and has not reported. One published finding deserves attention from anyone training: several randomized trials report metformin blunts the gains in muscle mass and, in some analyses, aerobic adaptation from resistance and exercise training in older adults. B12 deficiency develops with long-term use and is under-monitored. Lactic acidosis is rare but serious and relates to renal function.
Source
UK Prospective Diabetes Study (UKPDS) · Walton et al. 2019, Aging Cell — metformin blunts resistance training adaptation in older adults · TAME trial protocol (not yet reported)
Sources
No linked primary source is on file for this entry yet.
Educational use only, never medical advice. No doses.