Diabetes Canada is in close communication with Health Canada regarding an impurity known as N-nitrosodimethylamine (NDMA) which has been found in the diabetes medication metformin in jurisdictions outside of Canada. Given the wide-spread use of metformin, many Canadians will be concerned about the potential impact on their care. Health Canada is not aware of any metformin products in Canada containing NDMA above acceptable levels.
Diabetes Canada’s Clinical Practice Guidelines list metformin as generally the first choice for people with type 2 diabetes because of its safety, low cost and possible heart benefits. It works by making the body respond better to insulin so that a person’s body uses insulin more effectively.
As noted in Health Canada’s statement: “NDMA is classified as a probable human carcinogen. We are all exposed to low levels of nitrosamines through a variety of foods (such as smoked and cured meats, dairy products and vegetables), drinking water and air pollution. NDMA is not expected to cause harm when ingested at low levels. A person taking a drug that contains NDMA at or below the acceptable level every day for 70 years is not expected to have an increased risk of cancer.”
“We understand this news may raise questions and concern among the many Canadians living with diabetes who rely on metformin to manage their disease,” says Dr Jan Hux, president & CEO for Diabetes Canada. “It is important for all patients managing their diabetes with metformin to continue their treatment regimen and to work with their health-care provider to discuss potential options.”
Health Canada advised that testing is currently underway in Canada to determine whether any products may be affected, and we do not yet know of a specific timeline of when this review will be completed. “We have urged the Department to act swiftly in their review and communications,” says Dr. Hux.
Diabetes Canada will continue to provide updates through our newsroom and social media channels.