https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.16647
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It depends a lot on how the study is done. Obese people might benefit but others do not: No association between metformin initiation and incident dementia in older adults newly diagnosed with diabetes 2023
And even in obese people, GLP-1RAs do better than metformin:
- Associations of semaglutide with Alzheimer’s disease-related dementias in patients with type 2 diabetes: A real-world target trial emulation study 2025
- Associations of semaglutide with first-time diagnosis of Alzheimer’s disease in patients with type 2 diabetes: Target trial emulation using nationwide real-world data in the US 2024
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Thanks
The other difference above might be that Metformin can help prevent (as in the study Aging Doc) posted vs cannot reverse (or slow) AD once it has gotten going?
The paper concludes “The utility of metformin to prevent dementia was not supported.” so I don’t think metformin can prevent dementia. And if it does it’s probably a weak effect, certainly weaker than SGLT2i and GLP-1RAs (and their combination?).
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I found it interesting that he had energy markers, what are these?
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To be honest it is typical for him. He provides values, but does not explain what the units are. (Obviously percentages don’t have units, but they are percentages of something).
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Kobe University endocrinologist Ogawa Wataru says, "It is known that diabetes patients experience changes in the blood levels of metals such as copper, iron and zinc.
"In addition, chemical studies found that metformin has the ability to bind certain metals, such as copper, and recent studies showed that it is this binding ability that might be responsible for some of the drug’s beneficial effects. So, we wanted to know whether metformin actually affects blood metal levels in humans, which had not been clarified.
In the journal BMJ Open Diabetes Research & Care , the Kobe University team has published the first clinical evidence of altered blood metal levels in patients taking metformin. They showed that drug-taking patients have significantly lower copper and iron levels and heightened zinc levels.
Association of metformin treatment with changes in metal dynamics in individuals with type 2 diabetes,
BMJ Open Diabetes Research & Care (2025).
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