Type
2 diabetics can live longer than people without the disease
Patients treated with a
drug widely prescribed for type 2 diabetes can live longer than people without
the condition, a large-scale study involving over 180,000 people has shown.
The findings indicate
that a drug known as metformin, used to control glucose levels in the body and
already known to exhibit anticancer properties, could offer prognostic and
prophylactic benefits to people without diabetes.
Published in a leading
diabetes journal, Diabetes, Obesity and Metabolism by scientists from Cardiff University, the study set out
to compare the survival of diabetes patients prescribed with metformin with
patients prescribed with another common diabetes drug called sulphonylurea.
Importantly, the life
expectancy of these cohorts was also compared against non-diabetics who were
matched based on criteria that included age, gender, same general practice,
smoking status and clinical status.
"Patients treated
with metformin had a small but statistically significant improvement in
survival compared with the cohort of non-diabetics, whereas those treated with
sulphonylureas had a consistently reduced survival compared with non-diabetic
patients. This was true even without any clever statistical manipulation.
"Surprisingly, the
findings indicate that this cheap and widely prescribed diabetic drug may have
beneficial effects not only on patients with diabetes but also for people
without, and interestingly, people with type 1 diabetes. Metformin has been
shown to have anti-cancer and anti-cardiovascular disease benefits. It can also
reduce pre-diabetics' chances of developing the disease by a third.
"This does not
mean that people with type 2 diabetes get off Scott free. Their disease will
progress and they will be typically switched to more aggressive treatments.
People lose on average around eight years from their life expectancy after
developing diabetes. The best way to avoid the condition altogether is by
keeping moderately lean and taking some regular light exercise."
In the next phase of
the research, Professor Currie plans to investigate how patients prescribed
with metformin as a first line therapy can best be treated thereafter to ensure
that their life expectancy can be brought closer in line with the national
average.
Type 2 diabetes affects
8% of the US population and 6% of the UK population.
Effective glucose
control in diabetics is important in reducing the risk of microvascular
complications such as stroke or coronary artery disease. The stymying of these
conditions can initially be achieved through diet and exercise, but glucose
lowering medication is required in most patients with progressing diabetes.
Metformin is
recommended as first line therapy for type 2 diabetes in the current American
Diabetes Association and the European Association for the study of diabetes
guidelines. The National Institute for Health and Care Excellence (NICE) also
recommend the drug.
Sulphonylureas are
commonly prescribed if metformin is deemed by practitioners to be an unsuitable
course for treatment. Unlike metformin, sulphonylureas can cause weight gain,
hypoglycaemia and an impaired recovery after heart attacks. Conversely,
metformin is associated with beneficial effects, including improved cardiac
health and an ability to fight the onset of certain cancers.
Data used in study came
from the UK Clinical Practice Research Datalink, representing around 10% of the
UK population, where researchers identified 78,241 patients who were prescribed
metformin as a first-line therapy and 12,222 patients prescribed a
sulphonylurea as a first-line therapy. These were then each matched against
non-diabetic patient.
Story Source:
The above story is
based on materials provided
by Cardiff
University. Note:
Materials may be edited for content and length.
Journal
Reference:
1.
C. A. Bannister, S. E. Holden, S. Jenkins-Jones, C. Ll. Morgan,
J. P. Halcox, G. Schernthaner, J. Mukherjee, C. J. Currie. Can people with type 2
diabetes live longer than those without? A comparison of mortality in people
initiated with metformin or sulphonylurea monotherapy and matched, non-diabetic
controls. Diabetes,
Obesity and Metabolism, 2014; DOI: 10.1111/dom.12354
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Cardiff University.
"Type 2 diabetics can live longer than people without the disease." Science Daily,
7 August 2014. <www.sciencedaily.com/releases/2014/08/140807215552.htm>.
