Diabetes Discoveries & Practice Blog

Why Metformin?

Metformin: A 60-year-old drug that has been called a wonder drug for diabetes.

Stay tuned for an upcoming series on metformin where you will hear from the following experts discuss important attributes and considerations when using metformin for diabetes. Here's a sneak peek:

  • David Nathan, MD, Professor at Harvard Medical School and Director of the Diabetes Center at Massachusetts General Hospital
  • Janet Brown-Friday, RN, MSN, MPH, and Clinical Trials Manager at the Albert Einstein College of Medicine’s Diabetes Clinical Trials Unit
  • Jill Crandall, MD, Professor of Medicine at Albert Einstein College of Medicine
  • Kieren Mather, MD, Professor of Medicine at Indiana University

View Transcript

(David Nathan) Metformin has been the first choice for diabetes treatment for a long time, and it’s a consensus first choice. Everyone pretty much agrees that it should be the first choice. The reason for that choice is that it really fulfills all of the kinds of checkmarks that you’d like for a drug for a very common disease.

(Janet Brown-Friday) In terms of how you guide the patient to titrate their metformin, you have to look at who your patient is. There’s a combination of things that we would do to help somebody who has difficulty with taking metformin.

(Jill Crandall) The mechanism for low B12 with metformin, I don’t think has been completely sorted out, but it appears to be a problem with absorption. It’s not related to intrinsic factors—so the classic pernicious anemia that we all learned about in medical school, that’s not really the mechanism, but there seems to be something about the effect of metformin in the gut that impairs absorption.

(Kieren Mather) The long-term results of the Diabetes Prevention Program (DPP) tell us that the beneficial effect of metformin in terms of preventing or delaying the progression of diabetes persists over the entire 15 years of follow-up, and it’s looking to persist into the predictable future.

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