Summary
* A paper published in May 2025 used the Women’s Health Initiative (WHI) population data in a novel way. It aimed to examine the impact of metformin vs sulfonylureas on exceptional longevity, which the researchers defined as survival to at least the age of 90.
* The study only involved women over the age of 60 with type 2 diabetes and thus it is not generally applicable to other people.
* The researchers designed a hypothetical trial and then used the WHI population data to try to emulate this trial. Using a matching technique, they were able to match 219 women taking metformin and 219 taking sulfonylureas.
* They claimed that death before age 90 was 30% lower in the metformin group.
* This note reviews the methods, results, plausible mechanisms, author conflicts, drug adherence, strengths and limitations, as my notes usually do. However, there was one overriding issue, which I wrote to the lead author about. The reply did not overcome my concerns.
Zoe
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