157-OR: Is Metformin Associated with Frailty in Older Veterans with Diabetes?

Diabetes mellitus (DM) may promote accelerated aging fostering the development of frailty, a state of vulnerability to stressors resulting in higher morbidity, mortality and healthcare utilization, particularly among Veterans. Metformin may reduce the development of frailty by decreasing inflammation and insulin resistance. The aim of this study was to determine whether metformin is associated with a lower risk of frailty in older Veterans with DM. In a cross-sectional study, we evaluated 775 Veterans, 56.4% white, 77% non-Hispanic, 98.1% male, mean age was 72.73 (SD=6.83) years. Frailty was assessed using a 44-item frailty index (FI), which was constructed using the following variables: socio-demographic, medical and psychological comorbidities, number of medications, laboratory tests, and activities of daily living. Most patients were frail (FI≥0.21, n=393, 50.7%), followed by pre-frail (0.10> FI <0.21, n=359, 46.3%) and a few were robust (FI≤ 0.10, n=23, 3%). We evaluated the association using binomial logistic regression models with frailty status dichotomized as non-frail (robust and prefrail) and frail as the outcome variable and use of metformin as the independent variable. After adjusting for age, race, ethnicity, BMI, use of hypoglycemic drugs (insulin or sulfonylureas), DM complications, levels of glycemic control, and comorbidities, metformin use was associated with a lower risk of frailty (OR=0.520, 95% CI=.383-.707, p<.0005). These results suggest that metformin may reduce the risk of frailty in older adults with DM. Further studies assessing the benefits of metformin to prevent functional decline and promote healthier aging may be warranted.