Is metformin an anti-aging drug?

Abstract

Metformin, generally the first-line oral antidiabetic agent for both obese and non-obese type 2 diabetes mellitus (T2DM) patients, is able to reduce glycated haemoglobin (HbA1c) by approximately 1–1.5%, ultimately by reducing hepatic gluconeogenesis and counteracting the glucose-mobilising hormone, glucagon, in the liver.1 It also increases glucose uptake in skeletal muscle. Its anti-hyperglycaemic effects are critical for preventing the micro- and macrovascular complications associated with this common metabolic disorder. The risk of microvascular disease (retinopathy, nephropathy, and neuropathy) is increased by up to five times when HbA1c surpasses 7.5%, while hyperglycaemia increases cardiovascular disease risk by between two to four times, even when glucose falls within the prediabetes range.2 Although a percentage point sounds insignificant, each 1% decline in HbA1c is linked to a 21% risk reduction of any diabetes-related end point as well as diabetes-related death, to a 14% risk reduction of myocardial infarction, and to a staggering 37% risk reduction of microvascular complications.3 Noteworthy is that diabetes mellitus and cardiovascular diseases cause 22 million global deaths a year.4 The earlier glycaemic control is realised, particularly in the absence of established cardiovascular disease, the more likely macrovascular and mortality benefits are achieved. So, yes, for diabetics, metformin can extend the period spent in good health and the gains of intensive glucose management for preventing T2DM complications cannot be overemphasised.

Author Biography

Kim Outhoff, University of Pretoria

MBChB, PhD, DPM, ACCP (SA), FFPM (UK)
Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, South Africa

Published
2022-05-11
Section
Editorial