METFORMIN AND COGNITION IN OLDER PEOPLE
By Joseph GustaitisI
t’s been known for some time that
the long-term use of metformin,
one of the most common drugs used
to treat diabetes, is associated with
B vitamin deficiencies. Now a new
study indicates that metformin is also
associated with worse cognitive func-
tion in older adults—and B-vitamin
deficiency might be the reason.
The study, which was published in
The Journal of Clinical Endocrinology
and Metabolism, was led by Kirsty M.
Porter, PhD, of Ulster University in
Northern Ireland. The researchers,
who wanted to explore the relation-
ships between high blood sugar, B
vitamin status, and the use of metfor-
min, studied over 4,000 older people
(average age 74) who were taking part
in the Trinity, Ulster and Department
of Agriculture (TUDA) study.
The researchers divided the sub-
jects into three groups: those whose
blood sugar was normal, those who
had high blood sugar and were tak-ing metformin, and those who had
high blood sugar and were not taking
metformin. The researchers measured
the subjects’ levels of folate, vitamin
B12 and vitamin B6 and made cogni-
tive assessments using two standard
systems of measurement. “This is the
first study,” Dr. Porter and colleagues
pointed out, “to assess the impact of
hyperglycemia and metformin onthe biomarker status of all relevant B
vitamins...and to investigate associa-
tions with cognitive health.”
The researchers determined that
metformin use was associated with
higher risks of deficiency of both vita-
min B12 and vitamin B6. In addition,
after adjusting for other possibilities,
they reported that metformin use was
also associated with an increased risk
of cognitive dysfunction. Why might
this be? The researchers inferred that
“B vitamin deficiency may be impli-
cated” in the cognitive decline.
The investigators also reported,
however, that the consumption of
vitamin-fortified foods helps boost
the vitamin B levels. According to Dr.
Porter, “Fortified foods can provide a
bioavailable source of B vitamins and
may be beneficial for maintaining bet-
ter cognitive health in older people
with or at risk for diabetes,” but she
added, “This requires confirmation
in an intervention trial.” HALF-PRICE HUMALOG
INSULIN NOW AVAILABLE
By Diane Fennell
A
half-price version of Eli Lilly’s rapid-acting Huma-
log insulin, used by roughly 700,000 people in the
United States, is now available for order in pharmacies.
The generic form of the drug, known as Insulin Lispro
Injection, will cost $137.50 per vial, or $265.20 for a pack-
age of five KwikPens.
According to the company, the biggest savings will be
seen by those who are uninsured, have high-deductible
health insurance, or have Medicare Part D plans.
Because the product is identical to Humalog, pharma-
cists will be able to substitute the generic version. However,
some patients may still pay less for Humalog, depending
on their insurance.
In March, Eli Lilly announced plans to introduce the
lower-priced medicine.“The availability of Lilly’s Insulin Lispro Injection is
important progress that helps more people afford their
insulin,” stated Mike Mason, senior vice president, Con-
nected Care and Insulins. “Lilly will continue to work with
health plans, wholesalers, employers and the government
to work toward permanent solutions that will help every
person with diabetes afford their medicines.” NEWS &
NOTES
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