Lower COVID-19 death rate in women linked to diabetes drug metformin

The drug is used to manage blood sugar levels in type 2 diabetes patients

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Researchers have found that metformin—a common, generic type 2 diabetes medication used to manage blood sugar levels—is associated with significantly lower COVID-19 death risk in women. The study was conducted at the University of Minnesota Medical School and UnitedHealth Group, US.

However, the study also found that while the risk of death from COVID-19 is lower for women taking metformin, the result was not so in men.

As per the study published in Lancet Healthy Longevity, metformin not only manages blood sugar levels in patients, but also reduces inflammation proteins like TNF-alpha that appear to make COVID-19 worse.

People with diabetes have been observed to be vulnerable to greater risk of intensive care unit admission, intubation for mechanical ventilation, and death, possibly related to less effective glycemic, or blood sugar, control in these patients.

The researchers who are part of the study analysed over 6,000 people with type 2 diabetes or obesity who were hospitalised with COVID-19 from January to early June this year. They found an association that women with diabetes or obesity, who were hospitalised for COVID-19 disease and who had filled a 90-day metformin prescription before hospitalisation, had a 21 to 24 percent reduced likelihood of mortality compared to similar women not taking the medication. There was no significant reduction in mortality among men.

The team said that the analysis supports the “preventive use of metformin, before infection with SARS-CoV-2, to prevent severe COVID-19 in patients with diabetes or obesity”.

These results provide new directions for research against COVID-19, researchers said. However, they added that more research is needed.

The wide availability, low cost, minimal need for follow-up, and extensive safety data—even during pregnancy—for metformin add to the drug’s appeal to prevent severe COVID-19.

“If our findings are replicated in other analyses and prospective trials, metformin should be widely distributed for prevention of severe COVID-19 in people with diabetes or a BMI of at least 30 kg/m²,” the authors said. “Metformin is one of the few COVID-19 therapies that could be given to all adults, regardless of current or potential pregnancy status, as long as they do not have severe kidney disease.”

Principal investigator Assistant Professor Carolyn Bramante, who is part of the research team, has said that, in collaboration with Assistant Professor Christopher Tignanelli, they have submitted an Investigational New Drug (IND) application to the US Food and Drug Administration (FDA) for use of metformin for COVID-19 treatment and prevention, which was approved.

Bramante and Tignanelli have also received a donation from the Parsemus Foundation to conduct a multi-site prospective, randomised pilot study. This pilot trial will begin enrolling patients next week and will potentially lead into a larger trial.