Metformin use and mortality among patients with diabetes and atherothrombosis

January 01, 0001

Metformin use and mortality among patients with diabetes and atherothrombosis

Metformin is recommended in type 2 diabetes mellitus because it reduced mortality among overweight participants in the United Kingdom Prospective Diabetes Study when used mainly as a means of primary prevention. These investigators from multiple countries assessed whether metformin use was associated with a difference in mortality among patients with atherothrombosis. The study sample comprised 19,691 patients having diabetes with established atherothrombosis participating in the Reduction of Atherothrombosis for Continued Health (REACH) Registry between December 1, 2003, and December 31, 2004, treated with or without metformin.

They found: "The (2-year) mortality rates were 6.3% with metformin and 9.8% without metformin; the adjusted hazard ratio (HR) was 0.76 (signifiacnt). Association with lower mortality was consistent among subgroups, noticeably in patients with a history of congestive heart failure (HR, 0.69), patients older than 65 years (0.77), and patients with an estimated creatinine clearance of 30 to 60 mL/min/1.73 m2 (0.64)."

The authors concluded: "Metformin use may decrease mortality among patients with diabetes when used as a means of secondary prevention, including subsets of patients in whom metformin use is not now recommended. Metformin use should be tested prospectively in this population to confirm its effect on survival."

It seems that benefits of metformin are likely generalizable to most patients with type 2 diabetes.

For the full abstract, click here.

Arch Intern Med 170(21):1892-1899, 22 November 2010
© 2010 to the Anerican Medical Association
Metformin Use and Mortality Among Patients With Diabetes and Atherothrombosis. Ronan Roussel, Florence Travert, Blandine Pasquet, et al. Correspondence to Dr. Roussel: [email protected]

Category: T. Endocrine/Metabolic/Nutritional, K. Circulatory. Keywords: type 2 diabetes, metformin, atherothrombosis, mortality, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 14 December 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.