For years we were told that moving more and taking metformin was the ideal combination for keeping blood sugar under control. Two winning weapons, together, to fight diabetes and metabolic disorders. New research, however, invites us to review this belief and does so with data that deserve attention, especially for those who try to take care of their health every day with small concrete gestures, such as a walk or regular training.
Metformin is the most prescribed drug in the world for type 2 diabetes and is often recommended together with physical activity. The problem is that, according to the latest scientific results, this association may not work as we always thought.
Metformin and exercise together
The basic idea is simple and reassuring: if exercise is good for you and metformin works, together they should do even better. Yet the study tells another story. Researchers have observed that, in some people, metformin attenuates the very benefits of exercise that help improve insulin sensitivity and blood vessel health.
Translated into less technical words: those who train without taking the drug see their muscles respond better to insulin, their blood flows more easily and their blood sugar levels drop after meals. When metformin comes into play, however, these positive effects are weaker. They don’t disappear completely, but they lose strength, as if something were slowing down the body’s natural adaptation to movement.
And this is precisely the point that is most disturbing. Most people who take metformin are overweight or at risk of diabetes and exercise precisely to feel better, not just because of a number on the test report, but to feel more energetic, stronger, more stable.
What the study showed
The research followed a group of adults at risk of metabolic syndrome for sixteen weeks, dividing them into those who exercised with a placebo and those who exercised taking metformin. The results were clear. Physical activity alone improved insulin response, reduced inflammation, and lowered fasting blood sugar. It also increased overall physical fitness, an aspect that is often underestimated but fundamental to independence and quality of life.
However, when exercise was combined with metformin, the improvements were more limited. In particular, those taking the drug did not gain the same physical fitness as those who trained without it. This means less responsive muscles, lower resistance, less long-term benefits.
It is not the first time that science has raised this doubt. Previous studies have already suggested that metformin may also limit the effects of strength training by reducing the increase in muscle mass. Now the suspicion is that the drug interferes with both aerobic and resistance exercise.
The reason may be related to the way metformin works inside cells. The drug acts on the mitochondria, the energy plants of our body, partially reducing their activity. It is a useful mechanism for controlling blood sugar, but it could hinder the positive adaptations induced by exercise, those that make the body more efficient and trained.
It’s important to say this clearly: metformin remains an effective drug and exercise remains one of the most powerful strategies for preventing and managing diabetes. The study does not invite you to stop either one or the other. Rather, it opens up an uncomfortable but necessary question: are we sure that taking them together, at the same time, is always the best choice?
Some research suggests that starting drug therapy earlier and introducing physical activity later may bring greater benefits. Perhaps because the body has time to adapt to the drug and then responds better to the training stimulus. At the moment, however, there is a lack of long-term studies that directly compare these strategies.
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