Metformin
Reviewed by Maurice Lichtenberg
Metformin is a biguanide oral antidiabetic drug, first-line therapy for type 2 diabetes mellitus. It lowers hepatic gluconeogenesis and improves insulin sensitivity, partly via mitochondrial complex I inhibition and indirect AMPK activation. Observational data suggest reduced all-cause mortality and cancer incidence in diabetics, motivating the still-largely-unfunded TAME trial proposal (delayed since 2016, partial ARPA-H involvement announced 2024 but enrollment not yet confirmed). Off-label longevity use remains investigational; benefit in metabolically healthy people is unproven and may even blunt exercise adaptations.
Sources
- Barzilai N, Crandall JP, Kritchevsky SB, Espeland MA. (2016). Metformin as a Tool to Target Aging. *Cell Metabolism*doi:10.1016/j.cmet.2016.05.011
- Bannister CA, Holden SE, Jenkins-Jones S et al.. (2014). Can people with type 2 diabetes live longer than those without? A comparison of mortality in people initiated with metformin or sulphonylurea monotherapy and matched, non-diabetic controls. *Diabetes, Obesity and Metabolism*doi:10.1111/dom.12354