The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
the crude death rate in the group of people with type 2 diabetes who were on Metformin including the censoring was 14.4 so 14.4 deaths occurred per thousand patient years if you look at the control group it was 15.2 this was a startling result
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in both of these graphs the downward trending line from the controls so again non-diabetic not taking metformin is above the line corresponding to the diabetics who are taking metformin um put crudely um the people who are taking metformin that have diabetes are dying at a faster rate for every single year exam and the two lines do not overlap except at the beginning when everyone's alive it's like a foot race where basically the people with metformin and diabetes are falling behind and dying as they fall
Metformin reduces all-cause mortality - https://t.co/IlbA1p6j61
And people have taken tens of thousands of people who are on metformin for Type 2 diabetes, and looked at their overall health and their lifespan, and this fact that I'll tell you blows my mind. Type 2 diabetics that go on metformin, on average, live longer than people that don't have Type 2 diabetes. And they're protected against diseases. So if you're susceptible to cancer, or heart disease, frailty, those on metformin reduce their risk of those diseases, whereas those that don't take metformin, it increases over time.
So when we control for everything else what we see is that the people who were on Metformin are living longer.
then they took 78,000 people on metformin in 78,000 people who were non-diabetic again matching them and the 78,000 on metformin was metformin mono therapy mono therapy first line right and they watched their mortality so just to underline again the people on metformin had diabetes their control didn't have there were more obese than the control they also have more diseases than the control but they had significant less mortality 17% less mortality in the mid forming group
diabetics who take metformin when compared to diabetics who don't take metformin do better and when i say do better i mean they have lower mortality from all causes and lower mortality from very specific causes
the follow-up study was which was done by keys at all in 2022 um basically sought to improve on the methodology of the banister paper and it did something quite clever which is it repeated the analysis um using a different uh patient cohort so it's a Danish um patient population cohort um but it set up two studies within the study one very similar to what the banister uh experiment was and then one using a set of twins who differed only in that uh you know one had diabetes and one didn't so um what was interesting here so again that's a that's a clever design right it's and it's hard to do and um they actually found the opposite they found exactly what you would expect to find which is whether you were talking about identical twins fraternal twins unrelated people if you had type 2 diabetes even if you were on Metformin your risk of mortality was significantly higher and it varied anywhere from 33% higher uh to 80% higher again depending on the covariant analysis and the Cort the cohort that was being looked at