Continued metformin beneficial for diabetes with cirrhosis
Xiaodan Zhang, of the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues conducted a retrospective study of 250 patients with diabetes who were receiving metformin at the time of diagnosis with cirrhosis. The effect of continued therapy with metformin on survival was investigated.
The researchers found that 172 patients continued metformin therapy and 78 patients discontinued the medication. Median survival was longer in patients who continued metformin than in those who did not (11.8 versus 5.6 years overall; P < 0.0001). Similar patterns were observed for patients with Child-Pugh A scores or Child-Pugh B/C scores. Following multivariable adjustment, continued therapy with metformin remained an independent predictor of improved survival (hazard ratio, 0.43; P = 0.005). During follow-up, none of the patients experienced metformin-related lactic acidosis.
"Continuation of metformin after cirrhosis diagnosis reduced the risk of death by 57 percent," the authors write. "Metformin should therefore be continued in diabetic patients with cirrhosis if there is no specific contraindication."
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