UKPDS 34: Metformin in Overweight T2DM
The Lancet (1998)
Reduced all-cause mortality by 36% and diabetes-related death by 42% vs conventional therapy.
How it works
Marek's Guided Optimization® Program combines advanced lab testing, a dedicated health coach and medical provider, and a personalized treatment plan, all built around your data.
Resources
The process
1
Start your assessment
Complete your 45-min intake assessment
2
Get your labs drawn
4,000 partnered lab locations nationwide
3
Review with your coach
Screen-by-screen lab review
4
Receive your protocol
Treatment delivered to your door
Why Marek
The only program pairing you with a dedicated health coach and medical provider, built on precision diagnostics, with no subscription required.
Resources
Meet our co-founder
Derek
Co-Founder · MPMD Podcast
"Over time, I found it incredibly difficult to get medical oversight for myself and my family that reflected the latest research, and that was preventative. That's why I started Marek Health."
Excellent on Trustpilot
What we test
Every client's lab panel is hand-selected from 1,000+ available biomarkers, built around their specific goals.
Panel categories
Resources
Treatments
700+ medical provider-prescribed therapies built from your labs. Browse by category or explore the full formulary.
Metformin
Oral tablet ER (500mg, 750mg), Oral tablet IR (1000mg), Topical cream (100mg/mL + Resveratrol)Available in all 50 statesMarketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
weight
MetforminMetformin
World's most widely prescribed antidiabetic with 60+ years of use. Activates AMPK, inhibits mitochondrial complex I, and modulates mTOR, pathways central to aging biology. Foundational in longevity protocols; under investigation in the TAME trial.
HbA1c reduction 1.0 to 1.5%
Weight-neutral or modest reduction
No hypoglycemia as monotherapy
AMPK activation mimicking caloric restriction
No commitment · HSA/FSA eligibleNo commitment · HSA/FSA eligible
How it works
Mechanism of action
Inhibits hepatic mitochondrial complex I, increasing AMP:ATP ratio and activating AMPK. Suppresses hepatic gluconeogenesis, improves insulin sensitivity, modestly inhibits mTORC1, and activates autophagy.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
Clinical evidence
The research behind Metformin.
Metformin Improves Healthspan and Lifespan in Mice
Nature Communications (2013)
Extended healthspan with reduced metabolic decline and inflammatory markers when started late in life.
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Nausea, vomiting, diarrhea
- Metallic taste
- Vitamin B12 deficiency (long-term)
Less common but serious risks
- Lactic acidosis (rare, elevated with renal impairment)
- B12 deficiency with peripheral neuropathy
Generally not appropriate for
- eGFR <30
- Metabolic acidosis
- Active tissue hypoxia
- Major surgery or contrast (hold 48h)
Typical monitoring
- HbA1c every 3 to 6 months
- Renal function annually
- Vitamin B12 annually
- Liver function (baseline)
FAQ
Quick answers.
World's most widely prescribed antidiabetic with 60+ years of use. Activates AMPK, inhibits mitochondrial complex I, and modulates mTOR, pathways central to aging biology. Foundational in longevity protocols; under investigation in the TAME trial.
HbA1c reduction 1.0 to 1.5%. Weight-neutral or modest reduction. No hypoglycemia as monotherapy. AMPK activation mimicking caloric restriction. Epidemiologic association with reduced all-cause mortality and cancer.
Common side effects include: nausea, vomiting, diarrhea, metallic taste, vitamin b12 deficiency (long-term). Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
World's most widely prescribed antidiabetic with 60+ years of use. Activates AMPK, inhibits mitochondrial complex I, and modulates mTOR, pathways central to aging biology. Foundational in longevity protocols; under investigation in the TAME trial.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.