Additional file 1: Table S1. Baseline characteristics of included participants by asthma-COPD overlap status (n=3969). Table S2. Adjusted mean difference (95% confidence interval) in change of secondary outcomes from baseline to 5-year follow-up between metformin users and non-users. Table S3. Adjusted mean difference (95% confidence interval) comparing metformin users to non-users for cross-sectional secondary outcomes including participants without follow-up data. Figure S1. STROBE diagram of cohort derivation. Figure S2. Incidence rate ratio (95% confidence interval) comparing metformin users to non-users for exacerbations stratified by alternative alternative asthma-COPD overlap (ACO) definitions (n=3969)