Metformin Associated With Cognitive Impairment
Home / Conditions / Alzheimer's / Metformin Associated with Cognitive Impairment Metformin Associated with Cognitive Impairment Individuals taking metformin and who have a vitamin B12 deficiency are associated with an impaired cognitive performance. In a retrospective study led by Moore et al., diabetic patients taking metformin were monitored to see if they developed cognitive impairment. Those included in the analysis either came from the PRIME clinic study, or the AIBL study of aging. Patients with Alzheimers disease or mild cognitive impairment were included in the study, while individuals with stroke and neurodegenerative diseases were not. Results found that patients with diabetes had more severe symptoms of cognitive impairment than those who did not have the chronic disease (adjusted odds ratio 1.51 [95% CI 1.032.21]). Furthermore, participants with diabetes taking metformin displayed the worse cognitive performance among all subgroups (2.23 [1.054.75]). Diabetic participants who took vitamin B12 and calcium supplements presented with better cognitive performance. Researchers of the study mention that metformins lowering effects on cognitive performance may be tied to its lowering effect on vitamin B12 levels. This is because when vitamin B12 levels were increased via supplementation, cognitive performance was less impaired among patients. In conclusion, it can be seen that metformin is associated with impairing cognitive performance. However, taking vitamin B12 and calcium supplements with metformin may help decrease these outcomes. Future trials will be studying the effects vitamin B12 and calcium has in the older population with diabetes who are taking metformin. Moore EM, et al "Increased risk of cognitive impairment in patients with diabetes is associated Continue reading >>
Metformin In The Diabetic Brain: Friend Or Foe?
Diabetes is fast becoming the epidemic of the 21st century. Individuals with type 2 diabetes (T2D) are at an increased risk for developing cognitive disorders, such as Alzheimer disease (AD). To avoid or slow the development of T2D-associated complications anti-diabetic agents should be capable of achieving the desired glycemic and metabolic control goal, which should be as close to normal as possible. Metformin (1,1-dimethylbiguanide), an inexpensive, well-tolerated oral anti-diabetic agent is the most widely prescribed drug for treating T2D and is recommended, in conjunction with lifestyle modification (i.e., diet and physical activity), as a first-line oral therapy (1). Besides being highly effective in improving glycemic control, metformin has also a low risk of hypoglycemia. This anti-diabetic drug can be used at all stages of T2D progression, either as monotherapy or in combination with sulfonylureas and other secretagogues, thiazolidinediones, and insulin. The mechanism of action of metformin depends on alterations in cellular energy metabolism (i.e., increased AMP/ATP ratio). Metformin exerts its glucose-lowering effect by inhibiting hepatic gluconeogenesis and opposing the action of glucagon. Metformin-mediated inhibition of mitochondrial complex I results in defective cAMP and protein kinase A signaling in response to glucagon. Although unnecessary for the glucose-lowering effect of metformin, the stimulation of AMP-activated protein kinase (AMPK) confers insulin sensitivity, mainly through the modulation of lipid metabolism (2). Metformin can cross the blood-brain barrier and have specific effects on the central nervous system, although the exact mechanism and sites of its action remain uncertain. In addition, conflicting information exists about the benefici Continue reading >>
Metformin And Impaired Thinking
According to new research from Australia, the oral diabetes medicine metformin is linked to impaired brain function, but supplementation with vitamin B12 may reduce some of the cognitive effects. Metformin is the most widely used diabetes drug in the world, with over 61 million prescriptions for the medicine filled in the United States alone in 2012. To evaluate the effects of the drug on cognitive impairment in people with diabetes, researchers recruited 1,354 people from various locations in Australia. The researchers included people with Alzheimer disease and mild cognitive impairment, as well as those who were cognitively normal, but they did not include people with stroke or neurological conditions other than Alzheimer. The participants had an average age of 73.8 and almost 60% were female The study used an evaluation known as the mini-mental state exam to determine cognitive performance. According to the results, slightly more than half of the participants were not cognitively impaired, while 21.8% were minimally impaired, 17.7% were mildly impaired, and 10.1% were most impaired. In their analysis, the researchers found that people with Type 2 diabetes had worse cognitive performance than those without Type 2 and that, among those with diabetes, people taking metformin had worse cognitive performance than those not taking the medicine. Cognitive function scores were also found to be lower among those with vitamin B12 levels of less than 250 pmol/l. Because metformin is known to be associated with B12 deficiency, the investigators suggested that “any effect metformin has on cognitive performance may be at least partially mediated by altering serum vitamin B12 levels.” Limitations of the study include an insufficient amount of information about the duration of t Continue reading >>
Long-term Use Of Metformin Does Not Affect Memory, Thinking
Long-term use of the blood-sugar-lowering medicine metformin is not linked with cognitive impairment (problems with thinking, memory, and problem solving), according to new research from Columbia University Medical Center. Metformin is the most commonly prescribed diabetes drug in the world, with approximately 80 million prescriptions for the medicine filled in the United States alone in 2015. Previous research on metformin, thinking, and memory has had conflicting results, with some studies indicating that the medicine is linked to impaired brain function — perhaps in part due to vitamin B12 deficiency — and even Alzheimer’s disease, and other studies suggesting that it may improve memory. To further evaluate the association between metformin and cognition, researchers looked at data from more than 2,000 adults enrolled in the Diabetes Prevention Program Outcomes Study. The participants were randomly assigned to either lifestyle intervention (consisting of a diet and exercise plan), metformin, or placebo (inactive treatment) to determine the effects on brain function. In years 8 and 10 of the study, the subjects were given cognitive assessment tests. The researchers found no significant differences in cognitive performance in participants who had been taking metformin for 8 years compared to those in the lifestyle prevention or placebo groups, and no correlation was found between the length of metformin use and cognitive function. A higher HbA1c level (a measure of glucose control over the previous 2–3 months) at the time of cognitive testing was linked with worse brain function. The results of the study “should be incredibly reassuring to clinicians and patients who have read reports to the contrary,” noted lead study author José A Luchsinger, MD. “I th Continue reading >>
Metformin Use Does Not Help Beat Cognitive Impairment As Previously Thought
Metformin use does not help beat cognitive impairment as previously thought Metformin use does not help beat cognitive impairment as previously thought Omega-3 fatty acids shown to reverse islet autoimmunity in mice 05 April 2017 A new large-scale study has found that long-term metformin use does not help slow down cognitive decline in diseases of the aging brain. The findings are of importance because diabetes is a risk factor for a number of neurodegenerative diseases, and metformin , the first-line drug treatment for type 2 diabetes , may affect an important aspect of cognitive impairment in older adults. Scientists knew that having decreased insulin sensitivity negatively impacts memory formation and prevents insulin from doing its job, including preventing the build-up of plaque in Alzheimer's disease. Some studies hinted that short-term use of metformin might actually protect from cognitive impairment as the treatment helps correct insulin issues and promotes the formation of new neurons. This new research, however, suggests that this protective effect from metformin may be true only for a limited period of time. After following a total of 9,300 patients with type 2 diabetes for 12 years, Taiwanese researchers at Taipei Medical University found that long-term metformin increased the risk of both Parkinson's and Alzheimer's disease . The study showed that the longer a patient used metformin, here for more than 300 days and at doses greater than 240g, the higher the odds of developing these diseases later in life. In fact, the risk for Parkinsons disease or Alzheimers dementia went up over 50 per cent during a 12-year period in those who took metformin when compared to those who did not. The higher incidences of Parkinsons and Alzheimer's dementia were still signif Continue reading >>
Side Effects Of Metformin Are More Serious Than You Think
The Side Effects of Metformin can range from not so serious, to deadly, are the risks of Metformin and Glucophage side effects worth it? This page will give you information that might be able to help you decide that for yourself. Also known as Glucophage, this is an antidiabetic medicine most often used in those with Type 2 Diabetes who are also overweight. It’s also used extensively in women with Polycystic Ovarian Syndrome, a condition known as PCOS, which is often accompanied by higher blood sugar readings which often benefit from the blood sugar lowering effects of Metformin. While at first glance it seems that Side Effects of Metformin are rare, a closer look and a little math show that there are some serious problems that can occur when taking this drug, and others that can and should be prevented easily, but are usually not due to a medical community that simply does not use nutritional supplements in the prevention of even well-known, easily preventable Glucophage side effects. Vitamin B12 Deficiency Vitamin B12 and Folic Acid Deficiency are well-known and well-studied side effects of Metformin. Despite the fact that there have been many studies confirming this problem over and over again in the medical literature, just like the Side Effects of Nitrous Oxide, few doctors warn their patients of this or recommend that they take simple, cheap over the counter Vitamin B12 Supplements in order to avoid this potentially devastating nutritional deficiency. In addition, the long term use of the ‘antacid’ drugs known as H2 receptor antagonist or proton pump inhibitors like Famotidine or Omeprazole, some of the most widely prescribed drugs, can increase this risk, as is mentioned in the Omeprazole Side Effects page. The Vitamin B12 Deficiency Symptoms range anywhere Continue reading >>
Metformin And Dementia - The Good, The Bad, And The Ugly
Metformin ...a commonly prescribed drug to control blood sugar might increase the risk of Alzheimer’s disease. Metformin ...a common diabetic drug may help in fighting brain disorders like Alzheimer's or dementia Late last year a friend and reader of this blog suggested I look into the drug Metformin as possibly being beneficial in treating FTD. It was published all over the place that Metformin was a possible cure for Alzheimer's - even Time Magazine picked up the story. Well, it made for nice headlines, but after a couple months of digging more deeply into the actual research I am left a little confused, and very skeptical. To be sure you really have to dig deep to get a clear picture. If you were to Google "Metformin + Dementia" the results returned are overwhelmingly positive. If you Google "Metformin+increased amyloid" they are overwhelmingly negative. The way I see it, in my own demented mind, is that the research needs to be interpreted very conservatively when it comes to pointing a finger at Metformin as either a cause or a cure. It is probably neither. When I delved into the actual chemistry it appears that it is Insulin, rather than Metformin, that is causing the actual beneficial effects observed. Metformin serves to manipulate the uptake and activity of Insulin in the brain, and influences the utilization of glucose in the process. It all comes back to the original hypothesis that Amyloid and Tau overproduction and phosphorylization is a byproduct of brain cells being starved for nutrition, and overproducing those substances in a last-gasp effort at survival. That is just my oversimplified summary-interpretation of what is going on based on the result that Metformin alone causes an increase in amyloid, and Metformin along with Insulin reduces amyloid. Mor Continue reading >>
Metformin For Protection Against Alzheimer's, Cancer And Heart Disease?
With commentary by Nir Barzilai, MD, director of the Institute for Aging Research, Albert Einstein College of Medicine, and Brian Kennedy, PhD, president and CEO of the Buck Institute for Research on Aging. Metformin may influence fundamental aging factors that underlie many age-related conditions, including cancer, heart disease and Alzheimer's, says Nir Barzilai, MD, director of the Institute for Aging Research at Albert Einstein College of Medicine, the Bronx. "Metformin is generic, and it's cheap," Dr. Barzilai says. And accumulating data suggests that ''it interferes with the biology of aging." Aging, he says, is a primary risk factor for not only diabetes but also most of our big killers, such as Alzheimer's, heart disease and cancer. In animal and human studies, metformin has shown promise in slowing the aging process and halting diseases. To study the potential of metformin further, Dr. Barzilai plans to launch a large-scale study, Targeting Aging with METformin (TAME), to look at the effects of metformin compared to placebo. His team has already completed the MILES study, Metformin in Longevity, and are analyzing the results. In that study, they gave some participants metformin, at 1,700 milligrams a day, and others placebo. The aim was to see if the metformin could restore the gene expression profile of an older person with blood sugar problems known as impaired glucose tolerance (but not yet diabetic), to that of a younger person. Dr. Barzilai knows he has critics of his approach. He brushed them off, saying the people who don't see the value of the research ''don't understand the biology of aging and that it can be changed." He doesn't see the research as testing an anti-aging drug. "Aging is not a disease and we don't want it to be a disease," he says. Howe Continue reading >>
Diabetes Drug Metformins Primary Effect Is In The Gut, Not The Bloodstream Back
Diabetes drug Metformins primary effect is in the gut, not the bloodstream New study in Diabetes Care suggests new delayed-release metformin could help 40 percent of type 2 diabetes patients that currently cant take metformin. CHAPEL HILL NC, August 18, 2015 Although metformin was introduced as a treatment for type 2 diabetes nearly 60 years ago and is now the recommended first-line treatment for newly diagnosed patients, researchers still debate precisely how the drug works. Now, a study published online today in Diabetes Care by researchers at the University of North Carolina School of Medicine, Elcelyx Therapeutics, and other leading endocrinologists provides strong evidence that metformins primary effect occurs in the gut, not the bloodstream. The paper outlines results from phase 1 and phase 2 studies involving the investigational drug Metformin Delayed Release (Metformin DR), which is designed to target the lower bowel and limit absorption into the blood. Our clinical trials show that metformin works largely in the lower intestine, reversing half a century of conventional thinking, said John Buse, MD, PhD, first author of the paper, professor of medicine, and director of the Diabetes Care Center at the University of North Carolina School of Medicine. These findings create an opportunity to develop a new metformin treatment option for the 40 percent of patients that currently cant take this first-line drug of choice. Buse added, One of the top reasons metformin isnt used for all people with type 2 diabetes is that patients with impaired kidneys accumulate too much drug in the blood, and this can result in life- threatening lactic acidosis. These studies provide evidence that delivering Metformin DR to the lower bowel significantly reduces the amount of metformin i Continue reading >>
Metformin Reduces Dementia Risk
A new study adds to the growing body of evidence that metformin can help with overall health. Good news about metformin: it may help keep your brain healthy. The popular diabetes drug, which sensitizes the body to insulin and lowers glucose production in the liver, has been found to lower the risk of dementia in diabetes patients. A new Kaiser Permanente study found that the drug helped cut the risk of dementia by 20 percent. The study followed 15,000 Type 2 patients who were beginning to take one of four common diabetes drugs. During the course of the study, 10 percent of the studied population, as a whole, developed dementia, but those taking metformin had a 20 percent lower rate of dementia than the other patients. Dr. Rachel Whitmer, the studys author, said in a report that the findings illustrate that brain health is body health: The brain isnt isolated. When you think about your brain health you should be thinking about whole body health. The brain isnt isolated. When you think about your brain health you should be thinking about whole body health. The study results build on previous studies that found metformin helped patients, and mice, lower their risk of dementia. A 2010 University of Dundee study found metformin lowered the risk of Alzheimers disease in patients. Researchers say the drug may be effective in lowering the risk of mental impairment because it aids in the development of new brain cells, prevents brain cell death and reduces inflammation. Researchers still have to figure out why exactly metformin is helping in the fight against dementia and determine how best to utilize it to keep aging brains healthier. Continue reading >>
Side Effects Of Metformin May Cause Problems With Thinking: Study
The findings of a new study raises potential concerns about the side effects of meformin, suggesting that the popular diabetes drug may impair brain functions and cause users to experience problems thinking. Metformin is a widely used medication for treatment of type 2 diabetes, which is also known under the brand names Glumetza, Riomet, Fortamet and Glucophage. It is also part of several popular combination therapies, including the blockbuster medication Janumet, which combines metformin with the top selling diabetes drug Januvia. In a report published by the journal Diabetes Care, researchers compiled data from several different studies, including the Primary Research in Memory (PRIME) study; Australian Imaging, Biomarkers and Lifestyle (AIBL) study and data from the Barwon region of southeastern Australia. Researchers found that participants with diabetes performed worse on cognitive performance than those who did not have diabetes, with individuals taking a metformin drug performing significantly worse. More than 1,300 patients were evaluated who had Alzheimer’s disease, mildly impaired brain function and no cognitive impairments; along with a subset group which also had type 2 diabetes or impaired glucose intolerance. Patients who suffered a stroke or had neurodegenerative diseases other than Alzheimer’s were not included in the study. Patients with type 2 diabetes performed poorly on cognitive impairment tests and those who took metformin performed even worse. Researchers found metformin was associated with a vitamin B12 deficiency, which in turn resulted in impaired cognitive performance. Patients with vitamin B12 levels less than 250 pmol/L had the worst cognitive performance. Conversely, patients with type 2 diabetes taking metformin, but who also took calc Continue reading >>
Long-term Metformin Use 'has No Cognitive Impact'
Long-term Metformin Use 'Has No Cognitive Impact' The long-term use of metformin in individuals at risk of developing diabetes is not associated with worsening cognitive performance, say US investigators. The findings should reassure clinicians and patients alike that the drug is safe to use for diabetes prevention. Previous studies have suggested that metformin use may be associated with worse cognitive performance and perhaps even the development of Alzheimer's disease, while other studies have conversely indicated it may even improve memory. The current analysis of the Diabetes Prevention Program Outcomes Study (DPPOS), published online May 12 in Diabetes Care, shows that, in over 2000 adults, use of metformin for more than 8 years did not lead to cognitive impairment. Lead author Jos A Luchsinger, associate professor in epidemiology and medicine at Columbia University Medical Center, New York, told Medscape Medical News that "of all studies that have looked at the relationship of metformin and cognition, I think that, arguably, this is the best, because of the design, because of the exposure to metformin in a randomized trial setting, and the follow-up." He said that their finding that long-term exposure to metformin does not have a negative effect on cognition "should be incredibly reassuring to clinicians and patients who have read reports to the contrary." Dr Luchsinger added: "I think that's enormously important because metformin is the most used diabetes medication in the world, and it's the one that most people who get diagnosed with type 2 diabetes get started on." Higher HbA1c Linked to Lower Cognition, but No Link With Metformin Use The Diabetes Prevention Program (DPP) was a randomized controlled trial involving 3234 individuals with prediabetes in which Continue reading >>
Diabetes Drug Metformin May Impair Cognition, Study Finds
Diabetes Drug Metformin May Impair Cognition, Study Finds Metformin use in some patients with type 2 diabetes is associated with cognitive impairment that might be alleviated with vitamin B12 and calcium supplementation, a new study from Australia suggests. This isn't the first time metformin has been linked to cognitive problems stemming from vitamin B12 deficiency, but prior data have been conflicting, lead author Eileen M. Moore, PhD, a medical research scientist in the department of surgery, Deakin University, Geelong Hospital, Barwon Health, Geelong, Australia, told Medscape Medical News. Up to 30% of patients taking metformin may be deficient in B12, and this is thought to be due to an interaction between metformin and a receptor in the distal ileum, leading to some inhibition in the uptake of the vitamin, she and her colleagues say. However, she told Medscape Medical News, "Metformin remains a very effective first-line antidiabetic drug and may reduce cardiovascular risk in patients with diabetes. Clinicians and patients should not be alarmed by these findings, but the need to monitor and correct vitamin-B12 levels is highlighted." Adriaan Kooy, MD, PhD, director of the Bethesda Diabetes Research Center, Hoogeveen, the Netherlands, agrees. "This studyis highly interesting and asks for further research. The malabsorption of neurovitamins like B12 in metformin users may contribute to neuronal dysfunction potentially being misinterpreted as diabetic neuropathy," he noted. However, "it is unknown to [what] extent these changes might result in cognitive dysfunction," he added. And he too said there's no reason to panic. "There is insufficient evidence to be really concerned now. Why did the huge amount of epidemiological data not show any indication? Further evaluati Continue reading >>
Does Metformin Cause Memory Loss?
In this article, our pharmacist discusses whether or not metformin causes memory loss and how to reverse the effects. Does metformin cause memory loss? I feel as though the longer I have been on the drug, I have gotten worse. Answer Current evidence suggests that metformin does in fact have a negative effect on memory, although more studies are needed. Interestingly, early studies indicated that metformin showed potential promise in treating and preventing certain neurological conditions such as Alzheimer's Disease and Parkinson's Disease. In Vitro studies (i.e. studies conducted in the lab in a non-biological context) showed that metformin could prevent the formation of amyloid beta peptides, one of the hallmarks of neurodegeneration in Parkinson's Disease. Furthermore, studies in mice have shown that metformin promoted neurogenesis (i.e. generation of new neurons) and enhanced memory in rodents, as well as a overall reduction in oxidative stress. Unfortunately, these past results don't seem to have transferred over to the human use of metformin. Many current studies now show that metformin is associated with cognitive decline. In fact, there have been studies that suggest a nearly two fold increase in the likelihood of mental impairment in those taking metformin versus those who are not. Worse yet, metformin has been linked to an increased risk of developing dementia and Parkinson's Disease. One study followed over 9,000 patients for up to 12 years and found that the risk Parkinson’s disease, as well as dementia, increased over 50 percent during that period in those who took metformin. They concluded that long term metformin exposure in patients with diabetes may lead to the development of neurodegenerative diseases. The problem with most of the studies linking metf Continue reading >>
Study: Elevated Blood Sugar May Hurt Brain, Not Metformin
Study: Elevated Blood Sugar May Hurt Brain, Not Metformin A study found no link between metformin and worsening cognitionbut researchers found that whatseemed to harm cognition was instead, high blood sugar levels as indicated by an elevated HbA1c. Their findings may create confusion when compared toa recent study that leadto concerns about metformin and its possible influence on the development of Alzheimers and Parkinsons diseases, particularly with long-term use. In this study, researchers analyzed the association ofthe Diabetes Prevention Program (DPP) intervention arms which include lifestyle intervention, metformin, and use of a placebo in relation to cognition in the DPP Outcomes Study (DPPOS). In the study abstract the researchers wrote that they also analyzed for possible risk factors such as the use of metformin, the incidence of type 2 diabetes in the participants, and their blood sugar levels. How Did They Measure Cognitive Abilities and What Did They Find? The DPP study lasted nearly 3 years and was followed by a 13-month bridge to the DPPOS. The researchers checked cognition, or thinking skills in DPPOS in the studys year 8 and 10, with the Spanish English Verbal Learning Test (SEVLT), letter fluency tests, animal fluency tests, Digit Symbol Substitution Test (DSST), and a composite cognitive score. The cognitive assessments were given toa total of 2,280 participants with 749 undergoing the lifestyle intervention, 776 taking metformin, and 755 taking a placebo. Participants were a median age of 63, 67.7 percent were women, 54.6 percent were non-Hispanic white, 20.7 percent non-Hispanic black, 14.6 percent Hispanic, 5.5 percent American Indian, and 4.6 percent Asian. When the cognitive tests were done, type 2 diabetes cases were higher in the placebo group Continue reading >>
