Effect of metformin on microvascular outcomes in patients with type 2 diabetes: A systematic review and meta-analysis

Metformin: Is it a drug for all reasons and diseases?

“…Metformin has demonstrated cardiovascular benefits although it is unclear whether metformin is superior to newer agents such as the GLP-1 receptor agonists and SGLT-2 inhibitors. Interestingly the results of a meta-analysis of 19 RCTs with >18,000 subjects with T2D that was published in 2022 concluded that compared to other glucose-lowering drugs and placebo there was no evidence that metformin was clinically superior in protecting against the microvascular complications investigated [470]. However, benefits of metformin in kidney disease, retinal disease, neuropathy, and assessment of quality of life were not included in the studies [470].…”

“…Interestingly the results of a meta-analysis of 19 RCTs with >18,000 subjects with T2D that was published in 2022 concluded that compared to other glucose-lowering drugs and placebo there was no evidence that metformin was clinically superior in protecting against the microvascular complications investigated [470]. However, benefits of metformin in kidney disease, retinal disease, neuropathy, and assessment of quality of life were not included in the studies [470]. There is clearly a need for appropriately designed prospective studies, but it is unlikely that the equivalent of another UKPDS will be launched.…”

Peripheral Neuropathy: A review of mechanism-based treatments with a focus on metformin as a possible choice

“…Fakkar et al confirmed the previous study and mentioned that despite the lower levels of vit B12 in Metformin recipients, it is not associated with higher incidence of developing PN [77]. The last systematic review published in could not analyze the effect of Metformin on PN in diabetic patients due to the lack of data [78].…”

Guía mexicana de práctica clínica para el diagnóstico y tratamiento en pacientes adultos con diabetes tipo 2

“…Una RS muy reciente publicada por González et al en 2022 132 tuvo como objetivo evaluar el impacto de la metformina y de distintos antidiabéticos en desenlaces microvasculares (principalmente renales) en personas que viven con diabetes. Los autores incluyeron 19 ECA con un total de 18,181 participantes (56 años de edad y HbA1c del 7.8% en promedio), donde en seis de los 19 estudios se incluyeron pacientes con ECVA establecida.…”