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Metformin Dementia

Ten Myths About Metformin

Ten Myths About Metformin

Is metformin (Glucophage) bad for you? There is quite a bit of misinformation out there about this commonly used medication. Metformin therapy may cause diarrhea and lower vitamin B12 levels, but most things you hear about metformin aren’t true. Here are some common metformin myths. Metformin is bad for your kidneys. It’s not. What may be confusing folks here is that until 2016 patients with a creatinine level above 1.5 were advised not to take metformin. Metformin does not cause the kidney problems and in fact, 2016 labeling on Metformin was changed to indicate it should not be used only in those with late-stage chronic kidney disease stage IV or V. Metformin is bad for your liver. Truth is, it’s not. Metformin isn’t metabolized at all by the liver and instead is excreted unchanged in the urine. Metformin-induced liver injury is a rare, but possible adverse drug reaction that usually occurs at 4-8 weeks of therapy. Metformin is dangerous to take if you want to become pregnant. This is not true, and in fact may be the opposite. Metformin therapy during pregnancy in women with PCOS is associated with a reduction in miscarriage rate and gestational diabetes and did not adversely affect birth weight or development at 3 and 6 months of life. Metformin causes dementia. No. In fact a recent study of 17,000 diabetic vets found that taking metformin was associated with a lower risk of dementia than sulfonylureas like glyburide or glipizide. Other studies have shown metformin use to be associated with reduced rates of dementia and improved cognitive function. Metformin is bad for your heart. This is one I hear quite a bit from patients and it’s not true. Metformin has been suggested to exhibit cardioprotective effects in the setting of a heart attack. Metformin therapy Continue reading >>

Metformin And The Risk Of Dementia In Type 2 Diabetes Patients

Metformin And The Risk Of Dementia In Type 2 Diabetes Patients

Metformin and the Risk of Dementia in Type 2 Diabetes Patients 1Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan 2Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 3Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Zhunan, Taiwan Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks This retrospective cohort study investigated dementia risk associated with metformin use in type 2 diabetes patients by using the reimbursement database of the Taiwans National Health Insurance. The patients had new-onset diabetes during 1999-2005 and were followed up until December 31, 2011. An unmatched cohort of 147,729 ever users and 15,676 never users of metformin were identified, and a matched-pair cohort of 15,676 ever users and 15,676 never users was created by propensity score (PS). Hazard ratios were estimated by Cox regression incorporated with the inverse probability of treatment weighting using PS. Results showed that in the unmatched cohort, 713 never users and 3943 ever users developed dementia with respective incidence of 1029.20 and 570.03 per 100,000 person-years. The overall hazard ratio was 0.550 (95% confidence interval: 0.508-0.596). The hazard ratio for the first (<27.0 months), second (27.0-58.1 months) and third (>58.1 months) tertile of cumulative duration of metformin therapy was 0.975 (0.893-1.066), 0.554 (0.506-0.607) and 0.286 (0.259-0.315), respectively. Analyses in the matched cohort showed an overall hazard ratio of 0.707 (0.632-0.791) and the hazard ratio for the respective tertile was 1.279 (1.100-1.488), 0.704 (0.598-0.829) and 0.387 (0.320-0.468). In conclusion, metfor Continue reading >>

Metformin Linked To Lower Mortality In Diabetes With Dementia

Metformin Linked To Lower Mortality In Diabetes With Dementia

Metformin Linked to Lower Mortality in Diabetes With Dementia LISBON, Portugal For older patients with both diabetes and dementia, taking metformin was associated with a reduction in all-cause mortality while insulin was associated with an increased risk for heart failure (HF), new observational data suggest. When it comes to the impact of diabetes medications on cardiovascular outcomes in this patient population, "Insulin users, in general, fare worse across the board, even when adjusted for duration of diabetes," said Juraj Secnik, MD, and doctoral candidate, Department of Neurobiology, Karolinska Institute, Sweden. More frequent monitoring might be appropriate in these patients, especially for those starting insulin treatment, said Secnik. The longitudinal, register-based cohort study also showed that diabetic patients with dementia who take a dipeptidyl peptidase-4 inhibitor (DPP-4i) have a higher rate of myocardial infarction (MI). The study was presented at the Congress of the European Academy of Neurology (EAN) 2018. Worldwide, some 47 million people have dementia, each with an average of four comorbidities, Secnik told meeting delegates. An estimated 13% to 20% of patients with dementia, or about 6 to 9 million, also have diabetes. In a later interview with Medscape Medical News, Secnik noted that diabetes can affect dementia and vice versa. "Diabetes contributes to cognitive impairment, and dementia can hinder diabetes self-management." Yet few studies have looked comprehensively at this patient group, and there are no guidelines for when diabetes and dementia coexist, said Secnik. He added that most cohort studies and randomized, controlled trials are carried out before dementia diagnosis. "So it's not entirely clear what kind of strategy we should use when b Continue reading >>

Metformin Linked To Increased Risk Of Dementia And Parkinsons Disease

Metformin Linked To Increased Risk Of Dementia And Parkinsons Disease

Metformin Linked to Increased Risk of Dementia and Parkinsons Disease I need your input. This report got me worried enough to make me stop taking my daily dose of 1000 mg. Glumetza, extended release metformin. here are the links I wouldnt take it too seriouslysounds like the methods of the study were questionable, and other evidence suggests metformin has several beneficial longterm effects. These results were only presented at a conference so far (and lots of questionable science gets into conferences), so Id wait to see if it actually survives peer review (and if so, what it really looks like then) before making treatment decisions based on it. I wouldnt worry too much about this studys findings. These paragraphs contain reasonable expert skepticism. When asked for comment, Larry Ereshefsky, PharmD, with Follow the Molecule consulting group, Los Angeles, California, told Medscape Medical News that he was very surprised and skeptical about the results. He noted that the poster didnt explain how the investigators controlled for the confounders and didnt mention anything about alternative treatments for T2DM or hemoglobin A1c levels between the groups, which would affect the analyses. Its interesting and I would like to know more but I dont believe the findings based on whats up there, said Dr Ereshefsky, who was formerly a psychiatry and pharmacology professor at the University of Texas, San Antonio. Continue reading >>

Beyond Diabetes, Metformin May Prove To Be A ‘wonder Drug’

Beyond Diabetes, Metformin May Prove To Be A ‘wonder Drug’

In the past 2 decades, metformin has become a mainstay of type 2 diabetes management and is now the recommended first-line drug for treating the disease in the United States and worldwide. Available in the United States since 1995, metformin is an attractive therapy for clinicians and patients alike. Studies have found the agent to be safe and effective, and at about $4 for a 1-month supply of the generic, that option is affordable at a time when many prescription drugs are being priced out of reach for some patients. “Metformin is the first drug of choice, by all standards,” Oluwaranti Akiyode, PharmD, RPh, BCPS, CDE, professor and clinical pharmacist at Howard University School of Pharmacy, told Endocrine Today. “It’s a rarity that all experts agree on something. It is time-tested, proven, has good efficacy, a good safety profile and it’s cheap. Metformin has been around long before it came to the United States. That’s why I find it amazing that we only have one drug in that class.” New research is suggesting that metformin may hold promise in treating or preventing a whole host of conditions in patients with and without type 2 diabetes. Studies show metformin may be cardioprotective in patients with diabetes and beneficial in the presence of stable congestive heart failure. The agent also may help to increase pregnancy rate in polycystic ovary syndrome, provide breast and prostate cancer benefits, and offer neuroprotection that may reduce dementia and stroke risk, Akiyode said. Nir Barzilai, MD, an endocrinologist and director of the Institute for Aging Research at the Albert Einstein College of Medicine, said he hopes to work with the FDA to conduct an NIH/American Federation for Aging Research metformin trial later this year — Targeting Aging with M Continue reading >>

Does Metformin Increase Dementia Risk?

Does Metformin Increase Dementia Risk?

Here is evidence that metformin, especially at high doses and for long periods, is associated with increased risk for neurodegenerative diseases and dementia. Metformin and Neurodegenerative Disease: An Unknown Link? O Epidemiological studies link T2D with increased risk for neurodegenerative diseases, like Alzheimer Disease (AD) and Parkinson Disease (PD) O Research is conflicting about whether metformin contributes to the increased risk for neurodegenerative diseases in T2D . Some studies have linked metformin to decreased risk of dementia [1] . Others suggest increased risk of AD with long-term metformin [2] Taiwanese Study Evaluated Risk for Dementia, PD with Metformin[3] . Used insurance claims data from Taiwans National Health Insurance Research Database . Included patients 50 years, recently diagnosed with T2D O Minimized bias with propensity score matching; adjusted for age, sex, comorbidities, diabetes complications, medications PD and Dementia Risk Increased with Metformin 0 Parkinson disease: Significantly increased risk with metformin vs without . Risk over twice as high (HR 2.27, 95% CI 1.683.07, p<0.001) 0 All-cause dementia: Significantly increased risk with metformin . 66% increased risk (HR 1.66, 95% CI 1.352.04, p<0.001) 0 Alzheimers disease: Significantly increased risk with metformin . Risk over twice as high (HR 2.13, 95% CI 1.203.79, p<0.01) 0 Vascular dementia: Significantly increased risk with metformin . Risk over twice as high (HR 2.30, 95% CI 1.254.22, p<0.01) Longer Duration, Higher Dose Linked to Higher PD Risk 0 Longer Metformin Duration: Significantly increased risk for PD with metformin vs without . 180-299 days: 46% increased risk (HR 1.46, 95%CI 0.902.37, results NS) . 400 days: 4.5 times increased risk (HR 4.49, 95%CI 3.066.58, p<0.00 Continue reading >>

Evaluation Of Metformin On Cognitive Improvement In Patients With Non-dementia Vascular Cognitive Impairment And Abnormal Glucose Metabolism

Evaluation Of Metformin On Cognitive Improvement In Patients With Non-dementia Vascular Cognitive Impairment And Abnormal Glucose Metabolism

Evaluation of Metformin on Cognitive Improvement in Patients With Non-dementia Vascular Cognitive Impairment and Abnormal Glucose Metabolism 1Department of Neurology, Tianjin First Center Clinical College, Tianjin Medical University, Tianjin, China 2Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China 3Department of Neurology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China Edited by: Diego Ruano, Universidad de Sevilla, Spain Reviewed by: Christos Frantzidis, Aristotle University of Thessaloniki, Greece; ke Sjholm, Gvle Hospital, Sweden; Suowen Xu, University of Rochester, United States *Correspondence: Dawei Zang, [email protected] Yan Cheng, [email protected] These authors have contributed equally to this work. Received 2018 Feb 20; Accepted 2018 Jul 9. Copyright 2018 Lin, Wang, Ma, Wang, Gong, Zhang, Zang and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Objective: Recent studies have suggested that metformin can penetrate the bloodbrain barrier, protecting neurons via anti-inflammatory action and improvement of brain energy metabolism. In this study, we aim to investigate the effect of metformin on cognitive function in patients with abnormal glucose metabolism and non-dementia vascular cognitive impairment (NDVCI). Methods: One hundred patients Continue reading >>

Metformin Linked To Dementia, Parkinson's In Patients With T2dm

Metformin Linked To Dementia, Parkinson's In Patients With T2dm

Metformin Use Linked to Increased Dementia, Parkinson's Risk in Patients With Diabetes VIENNA, Austria — Long-term use of the diabetes medication metformin may increase the risk for neurodegenerative disease in patients with type 2 diabetes mellitus (T2DM), new research suggests. In a cohort study that followed about 9300 patients with T2DM in Taiwan for up to 12 years, the risk for Parkinson's disease (PD) or Alzheimer's dementia was more than double during a 12-year period for those who took metformin vs those who did not — even after adjusting for multiple confounders. In addition, outcome risks increased progressively with higher dosage and longer duration of treatment. The results were presented here at AD/PD 2017: The 13th International Conference on Alzheimer's and Parkinson's Diseases by Yi-Chun Kuan, MD, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. Interestingly, recent research has suggested that use of metformin may protect against neurodegenerative diseases. When asked about that, Dr Kuan told Medscape Medical News that "some studies have actually found positive [outcomes] but some have been negative ." So the researchers wanted to look into this using their own data. "We'd heard about a possible protective effect from metformin. However, we found the reverse," she said, but stressed that large-scale, prospective studies in other countries are needed to clarify the results. The investigators note that past research has shown a link between T2DM and increased risk for neurodegenerative diseases, but there's been "some question" about the association with specific diabetes medications. They examined records for patients with T2DM from the National Health Insurance research database of Taiwan, including 4651 who had metformin pre Continue reading >>

Side Effects Of Metformin: What You Should Know

Side Effects Of Metformin: What You Should Know

Metformin is a prescription drug used to treat type 2 diabetes. It belongs to a class of medications called biguanides. People with type 2 diabetes have blood sugar (glucose) levels that rise higher than normal. Metformin doesn’t cure diabetes. Instead, it helps lower your blood sugar levels to a safe range. Metformin needs to be taken long-term. This may make you wonder what side effects it can cause. Metformin can cause mild and serious side effects, which are the same in men and women. Here’s what you need to know about these side effects and when you should call your doctor. Find out: Can metformin be used to treat type 1 diabetes? » Metformin causes some common side effects. These can occur when you first start taking metformin, but usually go away over time. Tell your doctor if any of these symptoms are severe or cause a problem for you. The more common side effects of metformin include: heartburn stomach pain nausea or vomiting bloating gas diarrhea constipation weight loss headache unpleasant metallic taste in mouth Lactic acidosis The most serious side effect metformin can cause is lactic acidosis. In fact, metformin has a boxed warning about this risk. A boxed warning is the most severe warning from the Food and Drug Administration (FDA). Lactic acidosis is a rare but serious problem that can occur due to a buildup of metformin in your body. It’s a medical emergency that must be treated right away in the hospital. See Precautions for factors that raise your risk of lactic acidosis. Call your doctor right away if you have any of the following symptoms of lactic acidosis. If you have trouble breathing, call 911 right away or go to the nearest emergency room. extreme tiredness weakness decreased appetite nausea vomiting trouble breathing dizziness lighthea Continue reading >>

Metformin Linked To Increased Risk Of Dementia And Parkinsons Disease

Metformin Linked To Increased Risk Of Dementia And Parkinsons Disease

Home / Specialties / Geriatric Medicine / Metformin Linked to Increased Risk of Dementia and Parkinsons Disease Metformin Linked to Increased Risk of Dementia and Parkinsons Disease Study finds connection between duration of therapy in senior patients and development of neurodegenerative disease. In 2011, the Journal of Alzheimers Disease published the findings of a large Taiwanese study showing a protective effect against development of dementia in diabetes patients who were given oral antidiabetic agents. The cohort of over 100,000 subjects included patients over 50 with type 2 diabetes, who were free of dementia at initiation, and received either or both metformin and a sulfonylurea. The results suggested that while T2D carries a two-fold increase in the risk of dementia, use of metformin, sulfonylureas, or both can reduce the risk by up to 35% over eight years. Medscape recently reported that at AD/PD 2017 (the 13th International Conference on Alzheimers and Parkinsons Diseases), a group of Taiwanese neurologists presented the results of their own study looking at possible risk increases for Alzheimers and Parkinsons in people with type 2 diabetes, citing uncertainty about the effects of metformin on the risk of developing neurodegenerative diseases. Utilizing the National Health Insurance research database in Taiwan, 4,651 diabetes patients who had prescriptions for metformin were selected, along with an identically sized, matched control group of patients not taking metformin. Although the statistical methods were not made available at the time of this writing, the findings were rather striking. Patients were retrospectively followed over a 12-year period. With regards to Parkinsons disease, the event rate in metformin users was 6.85% (n=318) vs. non-users at 2.7 Continue reading >>

Metformin Associated With Increased Dementia Risk In African Americans With Diabetes

Metformin Associated With Increased Dementia Risk In African Americans With Diabetes

Metformin Associated With Increased Dementia Risk in African Americans With Diabetes The use of metformin may be associated with an increased risk for dementia in older African Americans with type 2 diabetes , according to research presented at theAlzheimers Association International Conference this week in Chicago, Ill. The study involved 953 African American participants with an average age of 74. The group was about 70% female and wereapart of the Indianapolis-Ibadan Dementia Project out of Indiana University-Purdue University at Indianapolis. The aim of this study was to identify risk factors for Alzheimers disease, dementia, as well as cognitive impairment and cognitive decline, by comparing two populations from very different environments elderly African Americans from Indianapolis, and the elderly Yoruba from Ibadan, Nigeria. Dementia happens in all populations, but people with diabetes were shown in previous research to have higher rates of dementia, says Dr.Sujuan Gao, a study author at Indiana University School of Medicine. We have not examined the association in other racial groups, as this study only enrolled African Americans, Gao points out. The participants were assessed for dementia every second or third year during follow-up. Of the individuals, 150 used metformin. During the follow-up period, it was found that87 individuals developed dementia. Researchers conclude the use of metformin was linked with a greater risk for incident dementia in the study. Further, they found that individuals using metformin were at increased risk for complications with diabetes. There was a significant association between metformin use and increased risk of incident dementia in African American participants with diabetes, researchers reported in Neurology Advisor . Further Continue reading >>

Metformin And Alzheimer’s: A Potential New Therapy?

Metformin And Alzheimer’s: A Potential New Therapy?

The diabetes drug may have a beneficial effect on neurodegenerative diseases. Metformin, a biguanide, is an oral diabetes medicine used to improve blood glucose levels in people with type 2 diabetes. There have been various studies on other uses of metformin. It may be beneficial in Alzheimer’s disease, stroke and other degenerative brain cell diseases. An animal study found that metformin helps neurogenesis and enhances hippocampus, a key pathway (aPKC-CBP). Type 2 diabetes doubles the risk of having dementia; though some studies show metformin helps reduce risk, other studies show antidiabetic medications like insulin are linked to increased risk of having dementia. Animal studies show that metformin recruits endogenous neural stem cells and also promotes the genesis of new neurons. Metformin, however, needs to have been used for a longer period before a drastic reduction in neurodegenerative disease and its neuroprotective nature is seen. The purpose of this study is to find a link between antidiabetic medications, especially metformin and other neurodegenerative diseases. Also, to know how long one has to be on these antidiabetics before the neuroprotective nature kicks in. A cohort study of type 2 diabetes patients who are 55 years and above and being managed on a monotherapy antidiabetic drug of either metformin, sulfonylurea (SU), thiazolidinedione (TZD) or insulin were observed in a period of 5 years. In the course of 5 years, dementia was identified in 9.9% of the patients. Comparing those taking metformin to those taking sulfonylurea, there was a 20% reduction in dementia in those taking metformin. The hazard ratio 0.79%, a 95% confidence interval of 0.65-0.95. For TZD, metformin had a 23% reduction in having dementia as compared to TZD with hazard ratio of Continue reading >>

Metformin Revisited

Metformin Revisited

Metformin is the most extensively used oral therapeutic agent for type 2 diabetes mellitus (T2DM). The American Diabetes Association recommends metformin as the first line treatment for T2DM in conjunction with rigorous physical activity and dietary restriction. K Sreekumaran Nair, M.D., Ph.D., with Endocrinology, Diabetes, Metabolism & Nutrition at Mayo Clinic's campus in Rochester, Minnesota, says: "With the rapidly expanding prevalence of T2DM, many novel oral therapeutic agents are emerging, but metformin continues to dominate, both as monotherapy as well as in combination with other medications, including insulin. Metformin can also prevent or delay the onset of T2DM in susceptible populations, such as those with prediabetes, fasting hyperglycemia or impaired glucose tolerance, and it is a safe treatment for pregnant women with gestational diabetes. "In women with polycystic ovarian syndrome, metformin is effective not only at improving insulin sensitivity, but also in enhancing their potential for fertility. Currently, over 150 million people worldwide are using metformin." Metformin is a highly desirable therapy for T2DM for a number of reasons. Haleigh A. James, M.D., an endocrine trainee in Endocrinology, Diabetes, Metabolism & Nutrition at Mayo Clinic's campus in Minnesota, notes: "One of its major advantages is that metformin does not cause significant hypoglycemia. Another advantage is that, unlike hypoglycemic agents such as sulfonylureas or insulin, metformin treatment is not associated with weight gain, but may cause modest weight loss. "Some reports indicate that metformin is associated with preferential fat loss, and it may impart mild anorexic effects via its hypothalamic actions. Although there are conflicting reports, metformin may reduce the risk of Continue reading >>

Metformin And Alzheimer's Disease, Dementia And Cognitive Impairment: A Systematic Review Protocol

Metformin And Alzheimer's Disease, Dementia And Cognitive Impairment: A Systematic Review Protocol

The disease burden of dementia in Australia has been estimated to total 121,737 disability adjusted life years (DALYs), making dementia the fourth leading cause of burden from disease in this context. 1 Alzheimer's disease is the most common form of dementia, representing 50% to 75% of cases. 1 Due to the aging population, this increasing prevalence of dementia is not expected to decline without a major breakthrough in prevention. Another disease with a troublingly high prevalence is diabetes, which affects around 5% of the population. 2 Diabetes has been strongly linked to the onset of dementia and Alzheimer's disease. 3 A meta-analysis of 28 longitudinal studies demonstrated that people with diabetes had a 73% increased risk of developing dementia and a 56% increased risk of developing Alzheimer's disease compared to the general population. 3 There is evidence supporting a number of different mechanisms that may underlie this association including: inflammation, oxidative stress, vascular effects (influencing the circulation of blood to the brain), increased cerebral -amyloid peptides, hyperinsulinemia, brain insulin resistance and the formation of advanced glycation end-products. 4-6 Ultimately, it is likely that the cause is multifactorial, however, a clearly influential factor is elevated blood glucose, which occurs as a direct consequence of diabetes and has been shown to cause impaired episodic memory even in people who do not have diabetes. 7 The biguanide metformin, a first-line antidiabetic drug for type 2 diabetes, acts as an insulin sensitizer and reduces blood glucose by increasing glucose uptake into muscles while reducing liver gluconeogenesis through the activation of AMP-activated protein kinase (AMPK). 8 The seminal study supporting the contemporary p Continue reading >>

Metformin & Your Brain | Cognitive Vitality | Alzheimer's Drug Discovery Foundation

Metformin & Your Brain | Cognitive Vitality | Alzheimer's Drug Discovery Foundation

1 meta-analysis for Alzheimer's prevention 2 small clinical studies in patients with mild cognitive impairment or mild Alzheimer's disease 6 observational studies for future Alzheimer's risk in patients with type-2 diabetes Multiple observational studies have reported varying results on whether metformin may be beneficial for preventing Alzheimer's disease in type 2 diabetes patients. Three studies reported a decreased risk for cognitive impairment or dementia in diabetic patients taking metformin compared to those not taking medication or taking other diabetes drugs [1] [2] [3] . Additionally, one meta-analysis suggested a trend for reduced risk of dementia with metformin use in diabetics [4] . Three other studies, however, reported an increased risk for impaired cognitive performance, dementia, or Alzheimer's disease with metformin use compared to those taking other medications [5] [6] [7] . One study reported that longer metformin use was associated with an increasing risk for dementia [6] . Several factors could account for the varying results. Many of these studies do not account for diabetes duration, severity, or how well diabetes is controlled [8] . Also, metformin is often used to treat mild diabetes, so patients taking other drugs may have more severe diabetes. Additionally, long-term metformin use can decrease vitamin B12 levels, which may be a potential risk factor for Alzheimer's disease. One study reported that when controlling for vitamin B12 levels, metformin was no longer significantly associated with increased risk of Alzheimer's [7] [9] . It is currently unknown whether metformin would prevent Alzheimer's disease in non-diabetic patients. Whether with metformin or another method, controlling diabetes is important for reducing your risk for Alzheimer' Continue reading >>

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