Long-term use of the blood-sugar-lowering medicine metformin is not linked with cognitive impairment (problems with thinking, memory, and problem solving), according to new research from Columbia University Medical Center. Metformin is the most commonly prescribed diabetes drug in the world, with approximately 80 million prescriptions for the medicine filled in the United States alone in 2015.
Previous research on metformin, thinking, and memory has had conflicting results, with some studies indicating that the medicine is linked to impaired brain function — perhaps in part due to vitamin B12 deficiency — and even Alzheimer’s disease, and other studies suggesting that it may improve memory.
To further evaluate the association between metformin and cognition, researchers looked at data from more than 2,000 adults enrolled in the Diabetes Prevention Program Outcomes Study. The participants were randomly assigned to either lifestyle intervention (consisting of a diet and exercise plan), metformin, or placebo (inactive treatment) to determine the effects on brain function. In years 8 and 10 of the study, the subjects were given cognitive assessment tests.
The researchers found no significant differences in cognitive performance in participants who had been taking metformin for 8 years compared to those in the lifestyle prevention or placebo groups, and no correlation was found between the length of metformin use and cognitive function. A higher HbA1c level (a measure of glucose control over the previous 2–3 months) at the time of cognitive testing was linked with worse brain function.
The results of the study “should be incredibly reassuring to clinicians and patients who have read reports to the contrary,” noted lead study author José A Luchsinger, MD. “I think that’s enormously important because metformin is the most used diabetes medication in the world, and it’s the one that most people who get diagnosed with Type 2 diabetes get started on.”
The investigators plan to give the participants another round of cognitive testing and also hope to perform brain imaging scans.
For more information, see the article “Long-Term Metformin Use ‘Has No Cognitive Impact’,” or the study’s abstract in the journal Diabetes Care. And to learn more about metformin, read the article “Metformin: The Unauthorized Biography,” by diabetes treatment specialist Wil Dubois.
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