A meta-analysis of 12 studies in Diabetic Medicine featuring 194,792 participants found that patients with diabetes who used metformin -- especially long-term metformin users -- had lower odds of developing neurodegenerative disease, compared with those who didn't use metformin.

However, the researchers note that high-quality randomized controlled trials are needed to further confirm the finding because of "substantial heterogeneity" among the examined studies.

SYSTEMATIC REVIEW

Metformin and the risk of neurodegenerative diseases in patients with diabetes: A meta-analysis of population-based cohort studies

 
https://onlinelibrary.wiley.com/doi/10.1111/dme.14821

ABSTRACT

Methods

Articles were systematically searched in PubMed, EMBASE and Cochrane Library databases. Pooled relative risks (RRs) with 95% CIs were obtained using a random-effects model. Subgroup analyses, sensitivity analyses and meta-regression were performed to identify the sources of heterogeneity and strengthen the results.

Results

Twelve population-based cohort studies involving 194,792 participants (94,462 metformin users and 100,330 metformin non-users) were eligible for inclusion in this meta-analysis.

The pooled RR of NDs reached 0.77 (95% CI 0.67–0.88) when comparing metformin users with non-users.

The effects were more prominent in long-term metformin users (≥4 years) (RR 0.29, 95% CI 0.13–0.44) and studies from Asian countries (RR 0.69, 95% CI 0.64–0.74).

The effect estimates were stable when stratified by subtypes of NDs, study designs, and control definitions (p for interaction >0.05). Meta-regression did not identify the coefficients as the sources of heterogeneity (all p > 0.05).

Conclusions

This systematic review and meta-analysis found that metformin use, especially long-term use, was associated with lower ND risk. However, because there was substantial heterogeneity among studies, high-quality randomized controlled trials are still needed to confirm this finding.

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