1,700 mg/day metformin may prevent diabetes in people with metabolic syndrome, finds study

A new study published in the journal of Diabetes Care showed that people chosen based on their metabolic syndrome can effectively avoid diabetes by taking 1,700 mg of MET daily. Nearly 90% of fatalities in Europe are caused by noncommunicable diseases (NCDs). Metabolic syndrome (MetS), characterized by a clustering of metabolic risk factors such as abdominal obesity, dyslipidemia, high blood pressure, and high fasting glycemia, is a significant risk factor for the development of NCDs.

A 1.5-fold increase in the risk of all-cause mortality, a 2.5-fold increase in cardiovascular mortality, a two-fold increase in the risk of coronary and cerebrovascular illnesses, and a 5-fold increase in the risk of type 2 diabetes are all caused by the MetS. This Metformin and Dietary Restriction to Prevent Age-Related Morbid Events in People With Metabolic Syndrome (MeMeMe) study examined whether 1,700 mg of metformin (MET) per day, with or without a Mediterranean diet intervention (MedDiet), could lower the cumulative incidence of major noncommunicable diseases in individuals with metabolic syndrome.

1 of 4 interventions was randomly allocated to 1,442 individuals which where MET (1,700 mg/day) plus MedDiet intervention (MET+MedDiet), placebo plus MedDiet intervention, MET (1,700 mg/day) alone, or placebo alone. On average, the participants were monitored for 3 years. The cumulative incidence of major non-communicable illnesses, such as cancer, type 2 diabetes, and cardiovascular diseases, was the main outcome. Type 2 diabetes incidence and the shifting frequency of metabolic syndrome were secondary outcomes.

The MET+MedDiet group had a crude incidence of 6.7 cases per 100 person-years, while the MET alone group had a crude incidence of 6.9, whereas the placebo plus MedDiet group had a crude incidence of 13.3, and the group receiving placebo had an incidence of 11.3. The reduction in type 2 diabetes was 80% and 92% lower in the MET and MET+MedDiet groups, respectively, when compared to a placebo, entirely explained the differences.

Overall, this study clearly shows that among individuals chosen for the existence of MetS, 1,700 mg/day of MET is an excellent way to avoid diabetes. After being randomly assigned, only 22 people stopped taking MET which indicated the recommended dosage was safe. Despite the MedDiet intervention by itself did not appear to be effective in lowering diabetes and MetS, it was helpful when combined with MET intake, which enhanced the effects of medication.

Reference:

Pasanisi, P., Oliverio, A., Baldassari, I., Bruno, E., Venturelli, E., Bellegotti, M., Gargano, G., Morelli, D., Bognanni, A., Rigoni, M., Muti, P., & Berrino, F. (2024). Metformin Treatment With or Without Mediterranean Diet for the Prevention of Age-Related Diseases in People With Metabolic Syndrome: The MeMeMe Randomized Trial. In Diabetes Care. American Diabetes Association. https://doi.org/10.2337/dc24-1597