Diabetes Care: Risk of anemia in type 2 diabetes with metformin.

A recent study published in Diabetes Care, an authoritative journal in the field of diabetes, was designed to assess the link between metformin and anemia risk of type 2 diabetes by analyzing randomized controlled trials (RPTs) and real-world population data.
anemia is defined as hemoglobin volume slt;11 g/dL.
in the Diabetes Outcome Progression Trial (ADOPT; n?3967) and the UK Prospective Diabetes Study (UKPDS; n?1473) RCT, the researchers used logistic regression to model nonlinear hybrid models of anaemia risk and changes in hematological parameters.
in the observed genetic analysis of diabetes audits and studies in the GoDARTS population of Scotland (n-3485), researchers used discrete time failure analysis to simulate the effects of accumulated exposure to metformin on anaemia risk.
in ADOPT, the ratio of anemia to anemia (OR) (95% CI) compared to sulfonylurea was 1.93 (1.10, 3.38) and the ratio of pyridine diketone was 4.18 (2.50, 7.00).
In UKPDS, the OR (95% CI) of metformin was 3.40 (1.98, 5.83), the OR corresponding to sulfonylurea was 0.96 (0.57, 1.62), and the orr corresponding to insulin injection was 1.08 (0.62, 1.87).
in ADOPT, hemoglobin and blood cell ratio decreased after 6 months of taking metformin, but did not decrease further after 3 years of taking it.
in UKPDS, hemoglobin was reduced by 3 years compared to other treatments.
in years 6 and 9, hemoglobin was reduced in all treatment groups, and no larger differences were observed in the metformin group.
goDARTS, every 1 g/day of metformin increases the risk of anaemia by 2% per year.
thus, metformin was associated with an early risk of anemia in people with type 2 diabetes, a finding consistent in two RCTs and confirmed in a real-world study.
mechanism for the early decline of hemoglobin is not yet clear, but given the time, it is not possible to cause vitamin B12 deficiency alone.
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