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Metformin, a generic and widely used medication that lowers blood sugar in people with type 2 diabetes, may prove helpful in the fight to control COVID-19.

Recent research published in The Lancet Healthy Longevity found that women with either obesity or type 2 diabetes who took metformin and who developed severe COVID-19 were less likely to die from the coronavirus, compared with patients who were not taking metformin.

According to the U.S. Centers for Disease Control and Prevention (CDC), more than 34 million Americans have type 2 diabetes, a condition that often overlaps with obesity. Meanwhile, obesity and type 2 diabetes are among the risk factors for more severe cases COVID-19 disease, according to the CDC. This creates a large pool of people who may be especially vulnerable to poor outcomes from SARS-CoV-2, the virus that causes COVID-19.

For the study, researchers reviewed nationwide claims data from a large health insurance provider between January 1 and June 7, 2020 or roughly the six months of the pandemic in the U.S. The final participant count included 6,256 people who had type 2 diabetes or obesity (a body mass index of 25 or more) and who had also been hospitalized with COVID-19.

The analysis revealed that women on metformin had about a 22 percent lower risk of dying compared with those not taking metformin. However, the researchers did not observe a difference in mortality for men.

Why the lower mortality rate in women? No one knows for sure, but the authors speculate that it may have to do with inflammation, which is the immune system’s process for fighting off things that can harm it, such as germs like the coronavirus. In addition to lowering blood sugar levels, metformin also reduces inflammation, which is pronounced not only in people with type 2 diabetes and/or obesity, but also in patients with COVID-19. In fact, an out-of-control inflammation response is what may be driving many of the serious complications of COVID-19 infection.

Inflammation may also explain the sex difference. Prior research has shown that metformin reduces inflammation more in women than in men.

Interestingly, metformin is often stopped when a patient is hospitalized, which may not be the best move if taking it can help prevent severe COVID-19 — though this still needs more research.

Metformin is not only generally safe, it is also very affordable, costing less than $4 for a month’s supply. “If the findings are reproducible, metformin could be widely distributed for prevention of COVID-19 mortality,” write the journal editors.

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Bramante CT, et al. Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis. The Lancet Healthy Longevity. December 3, 2020. doi: https://doi.org/10.1016/S2666-7568(20)30033-7.

Cetin M, et al. Microparticulate and nanoparticulate drug delivery systems for metformin hydrochloride. Drug Delivery. September 2015. doi: https://doi.org/10.3109/10717544.2015.1089957.

>People with Certain Medical Conditions. COVID-19. U.S. Centers for Disease Control and Prevention. December 29, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.

Type 2 Diabetes. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/type2.html.

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