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Thread: Metformin: it's not just for diabetics

  1. #11
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    Quote Originally Posted by chuckman View Post
    That wasn't what I said; at least, not what I had implied. I try to be neutral given that I am not an ordering provider. I get leery of claims of 'wonder drugs' when we've seen a) it can become politicized or monetized, and b) a lot of 'wonder drugs' end up being bad (i.e., phen-phen). I also try to apply by own analysis in my context of what I have seen work and not work.

    I think one reason we see metformin so popular is that it's been around for a while, it's cheap, and it has a known safety profile. I do doubt we'll see it go very far off-formulary for a lot of things. We are seeing clinically something called the 'COVID effect': providers NOT ordering meds so as to not be cast in the same light as ivermectin, etc. I am also seeing it prescribed less now in favor of SGLT2 meds, but a lot remains to be seen how those pan out over time.
    If you were without any sci/med background and or knowledge of met, and read the opening sentence "Ironically, it can be bad for the renal system and cause renal failure." would indicate to a reader the drug in inherently toxic to the kidneys, no? That's how I would read it. And, per modern recs from FDA etc, it's now not even contraindicated for those with mild/moderate CKD and the prior warnings no longer accurate apparently.

    In very rare cases, in specific diabetic populations, with severe CKD, it can cause acidosis, and that appears about it, which of course has no bearing on those the OP article is aimed at.

    I agree that we may not see it go very far off-formulary, but you'd be surprised how many docs are giving to patients that are not diebetics, and of course the concept of preemptive anti aging medicine and approaches are a foreign concept to most med pros. That too is changing. FYI, Met is the first drug for FDA’s approval of the first human study to see if metformin can protect against the multiple diseases of aging.
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  2. #12
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    Quote Originally Posted by WillBrink View Post
    If you were without any sci/med background and or knowledge of met, and read the opening sentence "Ironically, it can be bad for the renal system and cause renal failure." would indicate to a reader the drug in inherently toxic to the kidneys, no? That's how I would read it. And, per modern recs from FDA etc, it's now not even contraindicated for those with mild/moderate CKD and the prior warnings no longer accurate apparently.

    In very rare cases, in specific diabetic populations, with severe CKD, it can cause acidosis, and that appears about it, which of course has no bearing on those the OP article is aimed at.

    I agree that we may not see it go very far off-formulary, but you'd be surprised how many docs are giving to patients that are not diebetics, and of course the concept of preemptive anti aging medicine and approaches are a foreign concept to most med pros. That too is changing. FYI, Met is the first drug for FDA’s approval of the first human study to see if metformin can protect against the multiple diseases of aging.
    If I were without any sci/medical background or knowledge I sure wouldn't come to M4C as my first line of education lol....

    I get what you are saying. I do stand by my comments, though. And again, my comments come with an asterisk as a non-prescribing clinician. It's a fine line to weave being able to educate while not coming off as promoting. Kind of a version of caveat emptor.

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