New publications
Diabetes drugs reduce asthma attacks by up to 70% by changing treatment approaches
Last reviewed: 02.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Research has shown that common diabetes drugs are transforming asthma treatment by reducing the frequency of attacks, regardless of weight or blood sugar control.
A recent cohort study published in JAMA Internal Medicine looked at the effects of metformin and other type 2 diabetes medications on asthma attacks. The researchers found that:
- Metformin reduces the frequency of asthma attacks by 30%.
- Glucagon-like peptide-1 receptor agonists (GLP-1RA) further reduce seizure frequency by 40%.
These results were independent of weight, glucose levels and asthma phenotype.
Context
Asthma, obesity, and T2DM are closely linked. T2DM and related conditions increase the risk of asthma attacks and corticosteroid dependence, which worsens metabolic health. Metformin, the mainstay of T2DM treatment, is known to be safe, affordable, and has anti-inflammatory and lung-protective properties. Its mechanisms include:
- Activation of adenosine monophosphate-activated protein kinase (AMPK);
- Inhibition of fatty acid binding protein-4 related pathways;
- Decreased levels of insulin-like growth factor 1.
These mechanisms reduce inflammation and airway remodeling. Metformin has previously been suggested to reduce asthma attack frequency, but some studies have not controlled for factors such as smoking and blood sugar levels. In addition, GLP-1RAs have pulmonary effects, reducing bronchial hyperreactivity and asthma attack frequency. However, their combined action with metformin and their impact on different asthma phenotypes have remained poorly understood.
Description of the study
Data were obtained from the UK Clinical Practice Research Datalink Aurum database, which covers over 2 million adults. A total of 2,021,469 participants over 17 years of age with a diagnosis of asthma were included. Patients with type 1 diabetes, chronic obstructive pulmonary disease (COPD) or chronic kidney disease were excluded.
Methods:
- Several approaches were used for the analysis:
- Self-controlled case series (SCCS) design to control for constant factors such as genetics and socioeconomic status.
- Probability-of-treatment-weighted (IPTW) cohort analysis to eliminate bias.
Main result:
Frequency of asthma attacks over 12 months, defined as corticosteroid use, emergency department visits, hospitalizations, or death.
Factors to consider:
Age, gender, body mass index (BMI), blood sugar level (HbA1c), asthma severity, smoking history.
Results
Reducing the frequency of asthma attacks:
- In the SCCS analysis, metformin showed a significant reduction in asthma attack frequency (p < 0.001).
- In the IPTW analysis, the risk of asthma attacks in metformin users was reduced by 24%.
Additional effects of GLP-1RA:
- GLP-1RA provided an additional 40% reduction in seizure frequency.
Independence from other factors:
- The effect of metformin was the same regardless of BMI, blood sugar level, eosinophil level, asthma severity or gender.
Side effects:
- No association was found between metformin and irrelevant outcomes (eg, hospitalizations for other reasons), confirming the specificity of the data.
Conclusions
- Metformin reduces the frequency of asthma attacks by 30%, and the combination with GLP-1RA provides an additional 40% reduction.
- These results highlight the potential for repurposing antidiabetic drugs for the treatment of asthma.
- Further research and clinical trials are needed to confirm these effects and explore the mechanisms.