Most patients with type 2 diabetes are treated first with a medicine called metformin, which helps the body better use the natural insulin it produces. However, many doctors are reluctant to use metformin to treat patients who have kidney disease, which is a very common problem for people who have diabetes. This is because studies 50 years ago showed that drugs like metformin was dangerous for patients with kidney disease. Since then, it has become clear that metformin is safe in patients with very mild kidney disease, but we still do not know enough about metformin’s safety in people with more serious kidney disease.
We will use a large collection of medical records and laboratory results from patients with diabetes and kidney disease who are treated with metformin, compared with patients who are treated with commonly used alternative drugs.
We will analyze the blood sugar results and the number of people with side effects, including very low blood sugar. Our goal will be to determine which patients are better off taking metformin than other drugs, and whether metformin should be used in patients with serious kidney disease.
The results of this project will help inform patients with diabetes and their physicians about what medication to use to achieve the best outcomes. Patients will be partners in this project’s research from beginning to end. The patient partners will advise us about what research questions are most important to them and what kinds of analyses of the data to conduct. They will also help interpret the results. After the findings are known, patient partners will be part of the team that explains the study and its findings, and how diabetes care can be improved in the future.
^James Flory, MD, was the original principal investigator on this project.