COVID-19 & Metformin: What Diabetics Need to Know

If you have type 2 diabetes, you’re probably concerned about catching COVID-19 and developing serious complications. People with type 2 are at higher risk for serious cases of the disease caused by SARS-CoV-2. But if you’re taking the diabetes drug metformin, your chances of a COVID-19 related death are much lower, according to a study published in the peer-reviewed journal Frontiers in Endocrinology.   

What Is Metformin?

Metformin is the generic name for Glucophage, Glucophage XR, Glumetza, Fortamet and Riomet. It’s also combined with other medications to produce Glucovance, Metaglip, Avandamet, Actoplus Met, Janumet and Prandimet. It’s been clinically used to treat diabetes since the 1950s. However, over the last decade the drug has been associated with health benefits beyond insulin sensitivity such as helping prevent high blood pressure, kidney disease, cardiovascular disease and high cholesterol, while reducing the risk of heart failure and recurrent colon polyps. Now, it’s credited with reducing a COVID-19 mortality risk by threefold for patients using metformin in the months leading up to a COVID-19 infection. 

University of Alabama at Birmingham Covid-19 Study

Researchers at the University of Alabama at Birmingham (UAB) obtained 25,326 electronic health records (EHR) of people who were tested for COVID-19 between Feb. 25, 2020 and June 22, 2020 from UAB Hospital. Of those tested, 604 were positive; 311 were African Americans.  

Records of positive tests were categorized by age, gender, race, test results, body mass index and high blood pressure. HbA1c levels also were analyzed. Diabetes medications were tracked, but only the two most common diabetes drugs – metformin and insulin – were looked at more closely.  

Study Results

Results showed a disproportionately high number COVID-19 cases among African Americans and people with obesity, high blood pressure and type 2 diabetes. About 11 percent of cases were deadly and 93 percent of these deaths occurred in people over age 50. Besides age, being male and having high blood pressure also raised the risk of death, but not as high as type 2 diabetes did. An overall 67 percent of deaths in the study were among people with type 2 diabetes. And the association remained substantial even after factoring age, race, gender, weight and blood pressure.  

Results also suggested that individuals with diabetes taking metformin before their COVID-19 diagnosis had a 33 percent higher chance of surviving COVID-19 than their peers. Researchers don’t understand how metformin helps lower COVID mortality. Researchers questioned if metformin provided better than expected glycemic control and weight management, but blood sugar and body mass index were similar in COVID survivors with diabetes taking metformin and those who did not take metformin. 

“Other factors may play a more important role in terms of the metformin effects on outcome in the context of COVID-19” and type 2 diabetes, the researchers wrote. 

“Metformin has a lot of benefits beyond type 2 diabetes control,” says Bernard Kaminetsky, MD, medical director, MDVIP. “Previous studies have credited metformin with preventing inflammation and clotting, which are major factors in severe COVID-19 cases.” 

The results have led UAB scientists to wonder if metformin may protect high risk individuals from COVID-19 complications. However, more studies are needed to understand the benefits and risks associated with taking metformin.  

If you have questions about COVID-19, consult your doctor. Need a primary care doctor? Consider partnering with MDVIP. Find a physician near you and begin your partnership in health »