Trials of metformin (MF) as an anti-cancer drug have recently begun, enhancing its reputation as a ‘wonder-drug’, effective over a spectrum of life-threatening diseases whilst being highly cost-effective. The cancer story began following reports (wildly exaggerated, in my view) that insulin glargine increased the risk of cancer but this was not seen in patients taking concomitant MF. Allied to its beneficial impact on cardiovascular (CV) outcomes, MFs first-line position in ALL diabetes guidelines seems to have been consolidated. But how strong is the evidence?

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