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New analysis suggests a familiar diabetes medication may also boost the odds of reaching an unusually long life in women. Researchers comparing treatments found postmenopausal women who started metformin had a lower risk of dying before age 90 than those who began treatment with a sulfonylurea — an intriguing result that adds momentum to geroscience research into drugs that might slow biological aging.
What the study found and why it matters
Scientists in the US and Germany examined records from a long-running cohort of postmenopausal women to explore whether metformin, a first-line therapy for type 2 diabetes, is linked to "exceptional longevity". From the broader dataset they identified 438 women who had started either metformin or a sulfonylurea. Over an average follow-up of 14–15 years, those in the metformin group showed about a 30% lower risk of dying before age 90 compared with the sulfonylurea group.
The researchers used age 90 as a marker for exceptional longevity — a useful but somewhat arbitrary threshold that highlights outcomes at the far end of the survival curve. Still, a sustained difference over more than a decade of follow-up is notable, particularly because randomized controlled trials (RCTs) rarely span that long.
How metformin could influence aging
Metformin has been prescribed for decades to control blood glucose in type 2 diabetes, but laboratory and epidemiological studies have uncovered multiple effects beyond blood sugar. It's been described as a gerotherapeutic — a drug that targets cellular processes involved in aging. Proposed mechanisms include reduced DNA damage, modulation of metabolic and inflammatory pathways, and activation of genes associated with longevity.
Other studies have suggested metformin may protect the brain from age-related wear-and-tear and even lower the severity or risk of lingering post-infectious conditions such as long COVID. These effects fit the broader geroscience hypothesis: if biological aging can be slowed, the onset of many age-related diseases and disabilities could be delayed or prevented.
Why the results are promising but not definitive
Importantly, this study is observational. Participants were not randomized to treatments; they received clinical care based on physician decisions. That means differences between groups beyond the medications themselves — such as baseline health, socioeconomic factors, or care patterns — could influence outcomes.
Other limitations include the relatively modest sample size (438 people) and the lack of a placebo or untreated control arm. Still, the extended follow-up period (median 14–15 years) is a strength, permitting a longer view of survival than most clinical trials can provide.
What researchers recommend next
- Conduct randomized controlled trials to test metformin's causal effect on aging and lifespan in humans.
- Investigate biological markers that could explain how metformin impacts multiple aging pathways.
- Explore whether benefits vary by sex, age at treatment initiation, or underlying health conditions.
Implications for an aging world
With global populations skewing older, interventions that extend healthy life — not just lifespan — are increasingly important. If a well-established, affordable medication like metformin can safely reduce the burden of age-related disease, the public-health implications would be substantial. But translating observational signals into clinical guidance requires careful verification.
For now, metformin remains a cornerstone of diabetes care. Patients should not start or stop any medication based on observational findings alone; treatment decisions belong in discussion with a clinician who understands the individual risks and benefits.
Expert Insight
"This study adds another piece to a complex puzzle," says Dr. Laura Mendes, a geroscience researcher at a university medical center. "It strengthens the case for testing geroprotective strategies in long-term trials, but it also underlines that population studies can only point toward hypotheses. We need rigorous RCTs and biomarker work to move from association to action."
As geroscience advances, drugs like metformin will be studied not only for specific diseases but for their potential to modify biological aging itself. That research path could reshape how medicine approaches prevention and healthy longevity in the decades ahead.
Source: sciencealert
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