Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body’s response to insulin, a natural substance that controls the amount of glucose in the blood. Metformin is not used to treat type 1 diabetes, a condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood.
SOURCE: National Library of Medicine, at the National Institutes of Health
When some people learn they have diabetes, their first treatment response involves willpower instead of medication.
That’s a bad idea for people living with type 2 diabetes, say Kaiser Permanente researchers.
The sooner people with diabetes start taking metformin, the longer it remains effective, according to a study that included more than 400 Vancouver-area Kaiser members.
Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood. Metformin is not used to treat type 1 diabetes, a condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood.
SOURCE: National Library of Medicine, at the National Institutes of Health
The medication eventually stops working in most patients, forcing them to take other drugs to control their blood sugar. Each additional drug adds extra costs and the possibility of more side effects, including weight gain. Early use of metformin, an inexpensive generic pill, can help deter extra costs and side effects, researchers say.
“If you started early, within three months of diagnosis, you fail at a rate of 12 percent a year,” said Gregory Nichols, co-author of the study and an investigator with the Kaiser Permanente Center for Health Research in north Portland. For people who wait a year or more, the failure rate almost doubles.
“People are reluctant to go to medication, and that’s not exclusive to diabetes,” Nichols said in an interview Tuesday. “They go with diet and exercise, which not only is a viable option, but the primary thing anyway, so it’s easy for physicians and patients to say: ‘Give that a try.’ But the study shows that even if you want to try that, start the drug immediately, as well.”
The failure rate per year for patients who started taking metformin one to two years after diagnosis is 21.4 percent.
“The sooner they start taking metformin, the better and longer it seems to work,” wrote the study’s lead author, Jonathan B. Brown, an investigator with the Kaiser Permanente Center for Health Research. “This study suggests that to gain full benefit from metformin, patients should start taking it as soon as they find out they have diabetes.”
“We believe that starting the drug early preserves the body’s own ability to control blood sugar, which in turn prevents the long-term complications of diabetes like heart disease, kidney failure and blindness,” Nichols wrote in the report.
About 30 million people worldwide are diagnosed with type 2 diabetes every year.
The study was published in the March issue of Diabetes Care, a journal of the American Diabetes Association.
Researchers used electronic health records to follow nearly 1,800 people with diabetes in Kaiser Permanente’s health plan in Washington and Oregon for up to five years. About 15 percent of Kaiser’s Northwest membership is in Clark County.
This is the first study to compare metformin failure rates in a real-world, clinical practice setting. Other studies compared failure rates of metformin only in clinical trials.
Tom Vogt: 360-735-4558 or tom.vogt@columbian.com.
