Not a surprise, but good that it’s formally recognized. There was a lot of hope associated with metformin back in the day, not much of it panned out.
There will still be some people who are obsessed by Metformin. That is the nature of human cognition.
I think the biggest problem with metformin is that it offsets the benefits of exercise, which leads to many results being neutral or even negative. Given the U-shaped trend observed in the DPP trial, where people with the least diabetes progression actually had a higher risk of new-onset diabetes on metformin than on placebo, I’m glad the TAME trial never really got off the ground due to various issues, because it probably would have failed, which saved a lot of money.
Yes, that was one of the reasons why I quit metformin after a year of daily 500mg. That, and the fact that it did zilch for my prediabetes, affecting neither FBS nor A1c. My doc proposed escalating the dose, but by that time enough evidence came out re: exercise that I wasn’t interested. That was many years ago, but I never had a reason to reconsider - nothing that’s been established about metformin since, ever made me consider putting it back into my stack. For me, metformin just is not interesting as an intervention for my medical situation, but everyone has to evaluate their own needs.
Also, given the results of the Brad trial, it’s quite possible that even once-weekly metformin can’t offset its negative effects on exercise. I’ve even seen many professionals, like David Sinclair, talk about how to avoid metformin’s negative effects on exercise. His advice is not to take it on the day you exercise. That view is really unprofessional, because even if the drug is completely cleared from the blood, its effects on various signaling pathways tend to be long-lasting.