Metformin Reduces the Risk of Diverticula of Intestine in Taiwanese Patients with Type 2 Diabetes Mellitus

2022

Cancers

Self Cite

Background: Whether metformin might reduce the risk of multiple myeloma (MM) has not been extensively researched in humans. Methods: The study subjects were enrolled from the reimbursement database of Taiwan’s National Health Insurance. A total of 739,553 patients who had a new diagnosis of type 2 diabetes mellitus during 1999–2009 were identified. They were categorized as metformin initiators (metformin (+)) and non-metformin initiators (metformin (−)) based on the prescriptions of antidiabetic drugs that included metformin and did not include metformin within the initial 12 months, respectively. MM incidence was calculated after the initial 12 months of treatment group assignment until 31 December 2011. Hazard ratios based on intention-to-treat (ITT) and per-protocol (PP) approaches were estimated by Cox regression weighted by propensity scores. Results: In the ITT analyses, the respective incidence rates for 497,248 metformin (+) and 242,305 metformin (−) were 9.97 and 14.33 per 100,000 person-years. The hazard ratio that compared metformin (+) to metformin (−) in the ITT analysis was 0.710 (95% confidence interval 0.593–0.850). In the PP analysis, the respective incidence rates were 5.14 and 13.98 per 100,000 person-years, and the hazard ratio was 0.355 (95% confidence interval, 0.270–0.466). The lower risk of MM among metformin (+) was supported by subgroup and sensitivity analyses. Conclusions: Type 2 diabetes patients who are initiated with metformin treatment have a significantly lower risk of MM, especially when they adhere to metformin treatment.

Section: Discussionmentioning

confidence: 80%

The Risk of Multiple Myeloma Is Reduced in Metformin Initiators: A Retrospective Cohort Study in Taiwanese Patients with Type 2 Diabetes Mellitus

2022

Cancers

Self Cite

“…Occupation was categorized according to the Bureau of the NHI [ 17 ]: (I) civil servants, teachers, employees of governmental or private businesses, professionals and technicians; (II) people without a specific employer, self-employed people and seamen; (III) farmers and fishermen; and (IV) low-income families supported by social welfare and veterans.…”

Section: Methodsmentioning

confidence: 99%

“…It is currently the first-line antidiabetic drug used to treat hyperglycemia in patients with type 2 diabetes mellitus (T2DM) [ 5 ]. Metformin exerts a glucose-lowering effect with additional multiple pleiotropic benefits including anti-atherosclerosis, anti-inflammation, anti-neoplasm, anti-aging, anti-microbial, pro-osteogenesis and immune modulation [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

The Risk of Age-Related Macular Degeneration Is Reduced in Type 2 Diabetes Patients Who Use Metformin

2023

Pharmaceuticals

Self Cite

Background: Whether metformin may reduce the risk of age-related macular degeneration (AMD) requires confirmation. This study compared the risk of AMD between ever users and never users of metformin matched on propensity score (PS) in Taiwanese patients with type 2 diabetes mellitus. Methods: We enrolled study subjects from Taiwan’s National Health Insurance. A total of 423,949 patients with new onset diabetes from 1999 to 2005 were identified. After excluding ineligible patients and enrolling only patients aged between 50 and 79 years, we created 13,303 pairs of ever users and never users of metformin matched on PS. The patients were followed from 1 January 2006 to 31 December 2011. We estimated hazard ratios by Cox regression. Results: AMD was newly diagnosed in 506 ever users and 639 never users. The respective incidence rates (per 100,000 person-years) were 778.72 and 1016.62. The hazard ratio (HR) and 95% confidence interval (CI) for ever versus never users was 0.756 (0.673–0.850). While ever users were categorized by tertiles of cumulative duration (<31.8, 31.8–63.9 and >63.9 months) and cumulative dose (<947.1, 947.1–2193.5 and >2193.5 g) of metformin, a dose–response pattern was observed. For the respective tertiles of cumulative duration, the HRs (95% CIs) were 1.131 (0.961–1.330), 0.821 (0.697–0.967) and 0.464 (0.384–0.561), while compared to never users. For the respective tertiles of cumulative dose, the HRs (95% CIs) were 1.131 (0.962–1.329), 0.739 (0.624–0.876) and 0.525 (0.438–0.629). A risk reduction among ever users was observed for all tertiles of defined daily dose but was most remarkable for the third tertile with a defined daily dose of >0.64. Subgroup analyses suggested that the benefit of metformin could be similarly observed among men and women and for age subgroups of 50–64 and 65–79 years. However, patients with diabetic retinopathy would not be significantly benefited and metformin did not seem to be preventive for exudative AMD. Conclusion: In general, metformin significantly reduces the risk of AMD.

“…Table 1 shows the variables treated as potential confounders. The ICD-9-CM codes of the disease diagnoses have been reported previously ( 28 ). They were selected because of a potential correlation with the exposure (i.e., metformin) or the outcome (i.e., GPD) or because these diagnoses might have potential detrimental effects on the patients’ life expectancy that might have led to a biased calculation of the incidence.…”

Section: Methodsmentioning

confidence: 99%

“…In our previous observational studies conducted in Taiwan, we did show that metformin users, when compared to non-users, have a lower risk of various types of cancer including oral cancer ( 13 ), endometrial cancer ( 14 ), breast cancer ( 15 ), prostate cancer ( 16 , 17 ), kidney cancer ( 18 ), bladder cancer ( 19 ), liver cancer ( 20 ), pancreatic cancer ( 21 ) and malignant brain tumors ( 22 ). Additionally, metformin use has also been observed to be associated with a lower risk of non-cancerous diseases such as Helicobacter pylori infection ( 23 ), tuberculosis infection ( 24 ), dementia ( 25 , 26 ), inflammatory bowel disease ( 27 ), diverticula of intestine ( 28 ), hemorrhoid ( 29 ), varicose veins ( 30 ), osteoporosis/vertebral fracture ( 31 ), hypertension ( 32 ), atrial fibrillation ( 33 ) and heart failure ( 34 ). These findings support metformin’s anti-neoplastic, anti-inflammatory, anti-microbial and pro-osteogenic actions in humans.…”

Section: Introductionmentioning

confidence: 99%

Metformin and risk of gingival/periodontal diseases in diabetes patients: A retrospective cohort study

2022

Front. Endocrinol.

Self Cite

AimTo compare the risk of gingival and periodontal diseases (GPD) between ever users and never users of metformin in patients with type 2 diabetes mellitus.MethodsThe Taiwan’s National Health Insurance database was used to enroll 423,949 patients with new onset diabetes mellitus from 1999 to 2005. After excluding ineligible patients, 60,309 ever users and 5578 never users were followed up for the incidence of GPD from January 1, 2006 until December 31, 2011. Propensity score-weighted hazard ratios were estimated by Cox regression.ResultsGPD was newly diagnosed in 18,528 ever users (incidence: 7746.51 per 100,000 person-years) and 2283 never users (incidence: 12158.59 per 100,000 person-years). The hazard ratio that compared ever users to never users was 0.627 (95% confidence interval: 0.600-0.655). When metformin use was categorized by tertiles of cumulative duration and cumulative dose, the risk significantly reduced in a dose-response pattern when the cumulative duration reached approximately 2 years or the cumulative dose reached 670 grams. Analyses on the tertiles of defined daily dose of metformin showed that the reduction of GPD risk could be seen in all three subgroups but the benefit would be greater when the daily dose increased.ConclusionLong-term use of metformin is associated with a significantly reduced risk of GPD.