Start metformin early in type 2 diabetes

04/22/2010 - Articles

Start metformin early in type 2 diabetes

By: Susan Aldridge, medical journalist, PhD


Type 2 diabetes is a progressive disease and it is common to have to escalate medication to keep blood sugar under control. Metformin is a cheap, generic drug which is often used as first line therapy for those diagnosed with type 2 diabetes. A new study, from researchers at Kaiser Permanente, suggests that starting metformin as soon as possible after diagnosis of type 2 diabetes can make a real difference in helping slow the progression of the disease.

This study was done in a clinical practice, rather than clinical trial, setting so has real relevance to the everyday lives of people with type 2 diabetes. A group of nearly 1,800 patients with type 2 diabetes in Kaiser Permanente’s health plan in Washington and Oregon was followed for around five years through electronic health records. Metformin failed at a rate of only 12% a year in those starting it within three months of type 2 diabetes diagnosis. In those starting metformin within one to two years of diagnosis, failure rate was 21.4% and the rate was 21.9% among those starting the drug three years after diagnosis of type 2 diabetes. Failure was defined as rising blood sugar or the need to take a second drug to control blood sugar.

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,’ said study co-author Dr Gregory A. Nichols, an investigator at the Kaiser Permanente Center for Health Research. ‘The American Diabetes Association recommends that patients start taking metformin and make lifestyle changes as soon as they are diagnosed. This study provides more evidence to back up that recommendation.



Brown J, Conner C and Nichols G Secondary failure of metformin in clinical practice Diabetes Care March 2010


Created on: 04/22/2010
Reviewed on: 04/22/2010

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