Metformin and the Development of Asthma in Patients with Type 2 Diabetes

Int J Environ Res Public Health. 2022 Jul 5;19(13):8211. doi: 10.3390/ijerph19138211.

Abstract

We conducted this study to compare the risks of asthma development and exacerbation between metformin users and nonusers. Overall, 57,743 propensity score-matched metformin users and nonusers were identified from Taiwan’s National Health Insurance Research Database between 1 January 2000, and 31 December 2017. We used the Cox proportional hazards model with robust standard error estimates to compare the risks of asthma onset, exacerbation, and hospitalization for asthma in participants with type 2 diabetes (T2D). Compared with metformin nonuse, the aHRs (95% CI) for metformin use in asthma development, exacerbation, and hospitalization for asthma were 1.13 (1.06−1.2), 1.62 (1.35−1.95), and 1.5 (1.22−1.85), respectively. The cumulative incidences of asthma development, exacerbation, and hospitalization for asthma were significantly higher in metformin users than nonusers (p < 0.001). A longer cumulative duration of metformin use for more than 728 days was associated with significantly higher risks of outcomes than metformin nonuse. Our study demonstrated that metformin users showed significantly higher risks of asthma development, exacerbation, and hospitalization for asthma than metformin nonusers. Moreover, metformin use for more than 728 days was associated with higher risks of outcomes. A randomized control study is warranted to verify our results.

Keywords: asthma; exacerbation; hospitalization; metformin; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asthma* / complications
  • Asthma* / drug therapy
  • Asthma* / epidemiology
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / epidemiology
  • Hospitalization
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Incidence
  • Metformin* / adverse effects
  • Proportional Hazards Models
  • Retrospective Studies
  • Taiwan / epidemiology

Substances

  • Hypoglycemic Agents
  • Metformin

Grants and funding

This study was supported in part by Taiwan’s Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004), the MOST Clinical Trial Consortium for Stroke (MOST 109-2321-B-039-002). This work also received grants from the Taipei Veterans General Hospital (V101C-156, V108C-172, V109C-189) and the Ministry of Science and Technology, R.O.C (MOST 110-2314-B-075-027-MY3). These funding agencies had no role in study design, data collection, data analysis, decision to publish, or manuscript preparation. No organization provided funds to assist with the preparation of this paper, and data analysis was not performed by employees of funders or any author who received funding. The funders did not offer writing support. The corresponding authors had complete access to all data in the study and the final responsibility of the decision to publish.