Researchers from Weill Cornell Medicine-Qatar (WCM-Q) with colleagues from Canada and the US, recently reviewed the efficacy of the drug metformin, and whether it can protect against diseases other than type 2 diabetes. The review was published in Metabolism, a leading journal dedicated to human metabolism research.

In the late 1950s, metformin was used to treat type 2 diabetes. Today, the drug continues to be the preferred choice for millions of people living with the condition. A collection of encouraging pre-clinical and clinical findings has sparked interest in re-purposing the drug to treat several other diseases, such as COVID-19.

Drug for all reasons and diseases

Titled Metformin: Is it a drug for all reasons and diseases? the review was designed to evaluate the putative mechanism(s) of action of metformin, analyse the controversial evidence for metformin’s effectiveness in the treatment of diseases other than type 2 diabetes, assess the reproducibility of the data, and reach an informed conclusion as to whether metformin is a drug for all diseases and reasons.

The review concluded that the primary clinical benefits of metformin result from its insulin-sensitising and anti-hyperglycemic effects that secondarily contribute to a reduced risk of a number of diseases and thereby enhance healthspan. In addition, there is no evidence to suggest that metformin exerts significant direct anti-inflammatory effects other than indirectly via its positive effects on glucose metabolism.

As such, the anti-inflammatory and endothelial-vascular protective effects of the drug are likely to be the primary reason for health improvements witnessed in COVID-19 patients, especially since the most severely affected patients are clinically obese and carry pre-existing diabetes.

The WCM-Q contributing team

  • Dr Chris R Triggle, professor of pharmacology
  • Dr Hong Ding, associate professor of research in pharmacology
  • Dr Isra Marei, post-doctoral associate in pharmacology
  • Dr Ross MacDonald, librarian of scholarly communications
  • WCM-Q alumnus Dr Ibrahim Mohammed
  • fourth-year medical student Khalifa Bshesh

International collaborators

  • Kevin Ye, MSc, Simon Fraser University (Canada)
  • Dr Morley D Hollenberg, Cumming School of Medicine, University of Calgary
  • Dr Michael A Hill, Dalton Cardiovascular Research Center and University of Missouri (US)

According to Dr Triggle reviewed pre-clinical and clinical data highlight the benefits of metformin in protecting against a series of diseases. However, he said it is important to also keep in mind that since metformin is not metabolised and is excreted unchanged, the environmental impact of the drug is an emerging issue that has been linked to endocrine disruption in fish.

To date, based on a single study from Denmark that was published in 2022, the drug’s extensive use in type 2 diabetes has also raised concerns over its effects on human reproduction. Dr Triggle said more studies are needed to determine the full impact of metformin. That said, interest in metformin is likely to continue to grow in the years to come.

Dr Ding and Dr Triggle received support from the Biomedical Research Program (BMRP) at WCM-Q, while Dr Marei was supported by ECRA Award from the Qatar National Research Fund, a member of Qatar Foundation and the L’Oréal-UNESCO for Women in Science Middle East Regional Young Talents Program, 2020.

Follow this link to read the full review. 

Check out Marhaba’s FREE e-Guides for everything you need to know about Qatar.