Metformin is a first-line medication for treating type 2 diabetes and a branded version of of it called Glucophage is used in the United States. People with certain medical conditions including obesity and type 2 diabetes have an increased risk of severe COVID-19 and may need hospitalization, intensive care or mechanical ventilation. The risk of death from the illness is higher for these groups.
The visceral fat accumulating around organs leads to insulin resistance increasing the risk of developing type 2 diabetes. Visceral fat cells secrete inflammatory substances like Interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-a), and D-dimer which may be associated with severe COVID-19.
People with type 2 diabetes also have increased levels of TNF-a which contributes to insulin resistance. The anti-inflammatory cytokin IL-10 is present in lower levels in people with obesity and type 2 diabetes.
Metformin is a safe, effective, relatively inexpensive drug which elevates anti-inflammatory IL-10 levels while decreasing the inflammatory markers TNF-a and IL-6 in people with or without diabetes.
Metformin according to studies has been seen to have a greater effect on women than men in reducing inflammation. A study conducted on patients of 18 years or older who had a diagnosis of obesity and type 2 diabetes and been given metformin against those who weren’t showed that 20.2% of the ones in the non-metformin group died compared with 16.9% of the metformin group.
In people with type 2 diabetes or obesity the study found a 21-24% reduction in mortality among women who had filled a metformin prescription before hospitalization compared with women who had not.
In the U.S more than 42% of women have obesity and 16.2 million women have diabetes. The use of a medication which is relatively inexpensive, is available easily and is safer may significantly reduce COVID-19 related mortality.