Metformin linked to lower death risk after COVID-19 in diabetes
Over 12 months, the adjusted risk ratio for death was 0.61 for metformin prescriptions versus prescriptions for another diabetes drug.
Our read
Populations- Studied:
- Cohort study of 53,332 people with Type 2 diabetes and COVID-19, 12 months, against DPP4i users
- What changed:
- Death risk after COVID-19 was lower among metformin users than DPP4i users (adjusted risk ratio 0.61)
- The catch:
- More advanced diabetes in DPP4i users could partly explain their higher mortality
- In the record:
- The 716th paper on metformin with results in people; 2,266 on record in all. Its result on mortality agrees with 39 of 52 other findings on record; 6 point the other way and 7 found no change.
- Why it’s aging research:
- It studies an intervention with evidence of extending healthy life.
Editor of record: Boris Djordjevic · AgingResearch.News
Among 53,332 adults aged 30–85 with type 2 diabetes and COVID-19, a retrospective observational cohort study compared metformin prescriptions with prescriptions for dipeptidyl peptidase-4 inhibitors, another type of diabetes medicine. Prescriptions began at least 30 days before COVID-19 and remained active when the infection began. Women made up 52% of the metformin group and 59% of the comparison group.
After adjustment for measured differences, metformin prescriptions were associated with lower risk of death from any cause over 12 months. Probable Long COVID, identified by a model using medical records, was also slightly less likely, with an adjusted risk ratio of 0.87. Recorded Long COVID diagnoses showed no statistically significant association; the range of likely effects included no difference.
Why it matters
For older adults with type 2 diabetes, the study addresses whether a medicine already used for blood sugar control might also matter for survival after COVID-19.
Caveats
Prescriptions were not randomly assigned, so differences in health between the drug groups may have contributed to the mortality link. The cohort excluded people with stage 3–5 chronic kidney disease or end-stage kidney disease and adults outside ages 30–85.
From the paper
- Participants
We evaluated EHR data from 53 332 individuals with T2DM, including 50 965 individuals who were prescribed metformin during acute COVID-19 and 2367 who were prescribed DPP4i during acute COVID-19 (Table 1).
- Follow-up
This counterfactual intervention included ensuring at least one healthcare interaction during the 12-month follow-up period, and for Long COVID outcomes, no mortality during the follow-up period.
- Result
In our sample of 53 332 individuals with Type 2 diabetes and COVID-19, we found that metformin prescription was associated with a lower risk of all-cause mortality after COVID-19 (adjusted risk ratio [aRR]: 0.61, 95% CI: 0.51, 0.73).
- Limitation
The major limitation of our study is that we did not address the effects of initiating these drug classes during the acute COVID infection, thus limiting the causal interpretation of our findings.
Quoted word for word from the full text on dom-pubs.onlinelibrary.wiley.com.
Metformin is part of Bryan Johnson's Blueprint and David Sinclair's daily regimen in Lifespan
The paper
Metformin and Severe Post‐ COVID ‐19 Outcomes Among Individuals With Diabetes Mellitus
Stanford University School of Medicine Stanford California USA; University of Minnesota Minneapolis Minnesota USA
Diabetes, Obesity & Metabolism, Nov 5, 2026, Open access, CC BY-NC
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