
The MeMeMe randomized trial studied whether metformin (1,700 mg/day), with or without a Mediterranean diet (MedDiet), could reduce the incidence of major noncommunicable diseases (NCDs) in individuals with metabolic syndrome (MetS). The trial included 1,442 participants, randomly assigned to one of four groups: metformin alone, metformin + MedDiet, placebo alone, or placebo + MedDiet. The participants were followed for an average of three years, with the primary outcome being the cumulative incidence of type 2 diabetes, cardiovascular diseases, and cancer.
The study found that metformin was highly effective in reducing the risk of type 2 diabetes, with an 80% reduction in the metformin group and a 92% reduction in the metformin + MedDiet group compared to placebo. While metformin significantly lowered blood glucose levels, body weight, and waist circumference, there was no observed reduction in cardiovascular disease or cancer incidence. Interestingly, there was an unexpected increase in cancer-related deaths in the metformin groups, though this was attributed to chance and requires further investigation.
The Mediterranean diet alone did not significantly impact diabetes prevention, but when combined with metformin, it enhanced metabolic improvements, including reductions in LDL cholesterol, BMI, and waist circumference. The diet-focused intervention involved monthly educational sessions but was not intensive enough to induce major dietary changes.
Overall, the trial demonstrated that metformin is highly effective in preventing diabetes in individuals with MetS, reinforcing its potential role in early intervention and diabetes prevention strategies. The study suggests that metformin could be recommended for high-risk individuals even before diabetes develops, though further research is needed to explore its long-term effects, particularly concerning cancer risk. Meanwhile, the Mediterranean diet’s impact was modest unless paired with metformin, highlighting the need for more structured dietary interventions to achieve significant benefits.
Source: diabetesjournals.org/care/article/48/2/265/157575/Metformin-Treatment-With-or-Without-Mediterranean