Monday, December 13, 2010

Metformin, Diabetes and Death


Weekly Health Update:


Metformin, Diabetes and Death




"A critical weekly review of important new research findings for health-conscious readers..."


By, Robert A. Wascher, MD, FACS


Dr. Wascher

Dr. Wascher


Updated: 12/12/2010




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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I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making 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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Robert A. Wascher, MD, FACS


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Dr. Wascher's Archives:

12-12-2010: Metformin, Diabetes and Death


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11-28-2010: Mammograms Save Lives in Women with Family History of Breast Cancer


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3-14-2010: Nuts, Diet & Obesity


3-7-2010: Walnuts, Cholesterol, LDL & Triglycerides


2-28-2010: Soy Isoflavones & Recurrent Prostate Cancer


2-21-2010: Testosterone Supplements in Frail Elderly Men


2-14-2010: Pancreatic Cancer Risk, Sodas & Juice


2-7-2010: Vitamin D, Cardiovascular Disease & Death


1-31-2010: Concord Grape Juice Improves Memory


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12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk


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11-29-2009: Exercise & Prostate Cancer Risk


11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer


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11-1-2009: Exercise & Prostate Cancer Risk


10-25-2009: HPV Virus & Risk of Breast Cancer


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7-26-2009: Coronary Artery CT Scans & Cancer Risk


7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer


7-12-2009: Breast Cancer & Metformin (Glucophage)


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12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease


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


12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease


12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer




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