SAMIRA FARAH, MD; THU NGUYEN, Pharm D; and GARY KELSBERG, MD, Valley Family Medicine Residency, Renton, Washington SARAH SAFRANEK, MLIS, University of Washington Health Sciences Library, Seattle, Washington Am Fam Physician. Metformin does not seem to be an effective treatment for nonalcoholic steatohepatitis. There are no studies evaluating whether metformin improves long-term patient-oriented outcomes such as progression from NAFLD to nonalcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, or death from liver failure. Metformin does not improve anatomic outcomes (histologic or ultrasound features of the liver) or biochemical outcomes (alanine transaminase [ALT] and aspartate transaminase [AST] levels, or insulin resistance) in adults. Metformin does not improve liver histologic or biochemical outcomes, or body mass index (BMI) in adults with nonalcoholic steatohepatitis. (Strength of Recommendation: C, based on a meta-analysis of randomized, controlled trials [RCTs] evaluating laboratory parameters.) Similarly, metformin does not improve histologic or biochemical outcomes, or BMI in children and adolescents with NAFLD. (Strength of Recommendation: C, based on RCTs evaluating laboratory parameters.)2 Two placebo-controlled RCTs (N = 113) evaluating the effect of metformin (850 to 1,700 mg per day) on ALT and AST levels, insulin resistance, and BMI found no differences. Another RCT (n = 2,153) found no improvement in ALT levels after treatment with metformin (850 mg twice per day) vs. placebo.2Two RCTs (N = 52) evaluating metformin (500 to 1,000 mg per day) in patients with nonalcoholic steatohepatitis found that it did not improve liver histology, ALT and AST levels, BMI, or insulin resistance.1Chalasani N, et al. Clinical Inquiries provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Many people look for alternatives to diabetic pharmaceutical drugs like Metformin™. At Liver Medic, we receive many inquiries regarding drug interaction of alternatives with Metformin as a common concern. In the United States, approximately 26 Million people are diabetic, and of that 95% are Type II diabetics, a condition influenced by lifestyle not genetics. Before one starts blaming the diabetic victims, please review articles on GMOs and addictive processed foods. Many of the health hazards of these foods are deliberately hidden from consumers and short of having a degree in chemistry it’s difficult for the individual to determine danger levels.. Metformin is the generic name, but is also found in brand names such as; Glucophage™, Glucophage XR™, Glumetza™, Fortamet™ and Riomet™. Metformin is an oral medication that lowers blood glucose (sugar) by influencing the body’s sensitivity to insulin and is used for treating Type II diabetes. Metformin has even been used to treat liver disease.
Apr 1, 2003. Sir. Metformin is an orally active biguanide, and was found to reduce mortality and complications in obese diabetic patients in the UK. May 1, 2017. Metformin is associated with lower all-cause mortality in patients with moderate chronic kidney disease CKD, congestive heart failure CHF.