Weekly Health Update:
Metformin, Diabetes and Death
By, Robert A. Wascher, MD, FACS
The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.
Welcome to Weekly Health Update
“A critical weekly review of important new research findings for health-conscious readers”
METFORMIN, DIABETES AND DEATH
Metformin is a diabetes medication that is of great interest to me, and to other cancer specialists, because of intriguing research data suggesting that it may reduce the risk of cancer occurrence and cancer recurrence in people with diabetes. (Diabetes is, itself, a risk factor for certain types of cancer, including one of the most lethal of all cancers, pancreatic cancer.)
Metformin has been shown to be particularly beneficial in reducing the risk of death due to the complications of diabetes in overweight and obese patients, who are especially prone to developing diabetes. However, there has been some concern regarding the potential safety of metformin in patients with preexisting cardiovascular disease and kidney disease, and so this first-line diabetes medication has not been extensively prescribed to diabetic patients with these diseases. (Somewhat ironically, cardiovascular disease and kidney disease are, themselves, known complications of diabetes.) For this reason, the clinical research study that I will be discussing in today’s column is especially important to the estimated 24 million patients in the United States, alone, who have diabetes, and to the hundreds of thousands of diabetic patients who have already developed cardiovascular disease and kidney disease in the US.
This newly published study, which appears in the current issue of the Archives of Internal Medicine, reports on the results of the massive Reduction of Atherothrombosis for Continued Health (REACH) Study, which included 19,691 patients with documented diabetes. (The researchers involved in the REACH Study have been following this huge number of patient volunteers since they enlisted in the study between December 2003 and December 2004.)
The findings of this very large prospective public health study validate the findings of smaller prior clinical studies. In this study, diabetic patients with cardiovascular disease were significantly less likely to die during the course of this study if they took metformin instead of other diabetes medications (or no diabetes medication at all). The patients in this study who took metformin were 24 percent less likely to die when compared to the diabetic patients who did not take metformin. Among patients with congestive heart failure, which has until recently has been considered a contraindication to taking metformin, the use of metformin was associated with a 31 percent reduction in death due to all causes. Moreover, patients with other health conditions that have previously thought to preclude diabetes treatment with metformin also appeared to benefit from metformin in this study. Diabetic patients with cardiovascular disease who were older than 65 years were 23 percent less likely to die if they took metformin, while patients with decreased kidney function (estimated creatinine clearance of 30 to 60 ml/minute) experienced a whopping 36 percent decrease in the risk of death if they took metformin.
As this was an observational study (i.e., there were no randomized groups of patients, and there was no placebo-control group), it should be urgently followed with a prospective, randomized, placebo-controlled clinical research study to confirm these highly important clinical findings. Taken together, however, the findings of this pivotal public health study are certain to eventually expand the number of patients with diabetes who will be considered eligible to receive metformin!
For a complete discussion of metformin as a potential cancer prevention agent, as well as other important evidence-based approaches to cancer prevention, order your copy of my new book, A Cancer Prevention Guide for the Human Race,now! For the price of a cheeseburger, fries, and a shake, you can purchase this landmark new book, and begin living an evidence-based cancer prevention lifestyle today!
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Disclaimer: As always, my advice to readers is to seek the advice of your physicianbeforemaking any significant changes in medications, diet, or level of physical activity
Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author
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Copyright 2007 - 2010
Robert A. Wascher, MD, FACS
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Dr. Wascher's Archives:
12-12-2010: Metformin, Diabetes and Death
12-5-2010: Vitamin D and Depression
11-14-2020: Low Dose Aspirin Reduces Colorectal Cancer Risk
11-7-2010: Coffee, Tea, Caffeine and Brain Cancer Risk
10-14-2010: Gum Disease (Gingivitis) and Breast Cancer Risk
10-3-2010: Mammograms Between 40 and 49 Years of Age
9-19-2010: Fruits and Vegetables Improve Memory
9-12-2010: Low-Carb Diet and Risk of Death
8-1-2010: Physician Error
7-25-2010: Obesity and Cancer Risk
6-27-2010: Soy, Curcumin & Prostate Cancer Risk
5-30-2010: Medical Research Studies & “Spin”
5-9-2010: Soy Foods & Stomach Cancer Risk
4-18-2010: Coffee Improves HDL Cholesterol Levels
3-28-2010: Aspirin & Breast Cancer Survival
3-21-2010: Obesity, Alcohol & Liver Disease
3-14-2010: Nuts, Diet & Obesity
2-28-2010: Soy Isoflavones & Recurrent Prostate Cancer
2-14-2010: Pancreatic Cancer Risk, Sodas & Juice
1-31-2010: Concord Grape Juice Improves Memory
1-24-2010: Mozart, Music, Babies & Health
1-17-2010: Breast Cancer, Physical Therapy & Lymphedema
1-3-2010: Ginkgo Biloba, Memory & Cognitive Health
12-20-2009: CT Scans & Cancer Risk
11-29-2009: Exercise & Prostate Cancer Risk
11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer
11-15-2009: Breast Cancer Treatment & Chronic Pain
1-8-2009: Vitamin D & Breast Cancer Risk
11-1-2009: Exercise & Prostate Cancer Risk
10-25-2009: HPV Virus & Risk of Breast Cancer
10-11-2009: Vitamin D & Falls in the Elderly
10-4-2009: Surgery, NSQIP, Complications & Death
9-27-2009 Stress, Heart Disease, Exercise & Death
9-20-2009: Vitamin D & Colorectal Cancer Survival
9-13-2009: H1N1 Swine Flu Update
9-7-2009: Green Tea, Aging & Lifespan
8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber
8-23-2009: Update on Prostate Cancer and Cryotherapy
8-2-2009: Honesty, Dishonesty & Brain Function
7-26-2009: Coronary Artery CT Scans & Cancer Risk
7-12-2009: Breast Cancer & Metformin (Glucophage)
7-5-2009: Prostate Cancer & Green Tea
6-21-2009: Red Yeast Rice, Statins & Cholesterol
6-7-2009: Diet, Soy & Breast Cancer Risk
5-31-2009: Diet and Prostate Cancer Risk
5-24-2009: Diabetes, Glucose Control & Death
5-10-2009: Hemorrhoids & Surgery
4-26-2009: Are We Really Losing the War on Cancer?
4-19-2009: Exercise in Middle Age & Risk of Death
4-12-2009: Can Chronic Stress Harm Your Heart?
3-15-2009: Depression, Stress, Anger & Heart Disease
10-26-2008: Smoking & Quality of Life
10-19-2008: Agent Orange & Prostate Cancer
10-12-2008: Pomegranate Juice & Prostate Cancer
9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?
4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function
4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)
12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality