Efficacy of Metformin in Prevention of Glucocorticoid-Induced Hyperglycemia in Patients Without Diabetes: A Meta-Analysis
Abstract
PURPOSE: The glucocorticoids are increasingly being used in the management of different autoimmune conditions and cancers. Our meta-analysis aims to leverage metformin's potential to reverse the metabolic complications of glucocorticoids by activating AMP-activated protein kinase (AMPK), while sparing their anti-inflammatory benefits.
METHODS: PubMed, Cochrane Library, trial registries and Google Scholar were searched from inception to June 2025 for Randomized Controlled Trials (RCTs) and observational studies comparing metformin and placebo to prevent metabolic side effects of glucocorticoid therapy in non-diabetic patients. After screening by two independent reviewers according to PRISMA guidelines, four studies involving 187 patients were analysed using the random-effects model in RevMan 5.4.1, and mean differences (MD) were calculated.
RESULTS: Preventive metformin administration during glucocorticoid treatment is superior to placebo with respect to glycaemic control as shown by statistically significant reduction in fasting blood glucose [MD = -0.60 (95% CI: -0.86 to -0.34)], HOMA index of insulin resistance [MD = -0.53 (95% CI: -0.97 to -0.08)], LDL levels [MD = -0.20 (95% CI: -0.40 to -0.00)] and total cholesterol [MD = -0.27 (95% CI: -0.54 to -0.01)]. However, our study failed to show significant improvement in area under the curve glucose (mmol/L × min) after challenge [MD = -176.66 (95% CI: -415.42, 62.11)], basal metabolic rate (BMR) [MD = 51.99 (95% CI: -53.08,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 187 participants or records.
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