Long-term use of metformin and lifestyle changes reduce the risk of developing type 2 diabetes, but do not affect the likelihood of cardiovascular disease, the results of the DPPOS (Diabetes Prevention Program Outcomes Study) study, published in the journal Circulation, showed.
The analysis showed that the risk ratio for heart attack, stroke and death from cardiovascular disease among patients who took long-term metformin was 1.03, and in the lifestyle group it was 1.14, compared with participants who received placebo.
Additional analysis taking into account gender, age, race-ethnicity, time of diagnosis of type 2 diabetes and use of additional medications (statins, antihypertensive drugs) also did not reveal the effect of metformin and lifestyle changes on the likelihood of cardiovascular disease.
Scientists from the University of Miami, the University of Pittsburgh Graduate School of Public Health, Albert Einstein College of Medicine, and the National Institute of Diabetes and Digestive and Kidney Diseases examined the results of the DPP (Diabetes Prevention Program) and the DPPOS study.
The DPP program enrolled 3,234 people with impaired glucose tolerance. Patients were randomized to metformin (850 mg twice daily), intensive lifestyle intervention, or placebo. The observation period was three years.
Over the next 18 years, all participants were offered less severe lifestyle changes as part of the DPPOS study. Patients receiving metformin continued taking the drug.
The researchers assessed the incidence of myocardial infarction, stroke or death from cardiovascular disease in all groups. In addition, the risk of coronary heart disease, hospitalization due to heart failure or unstable angina, and coronary or peripheral revascularization was monitored.
The total follow-up period was 21 years. During this time, 310 cases of heart attack, stroke and death from cardiovascular disease were identified among participants.