Background: CLL is an indolent disease with long disease course and is notable for one of the oldest median ages of onset of all cancers. As such, patients have the potential for many years of life after diagnosis. Prior studies in solid tumors, as well as our own prior research with DLBCL, have shown that Metformin improves outcomes. We sought to investigate the Roswell Park CLL database to look at real world trends from our experience. Methods: 977 patients were identified from the Roswell Park database that were seen for CLL between Jan 1990 to June 2017. 629 of those patients were seen primarily at Roswell Park with the other 348 being seen as second opinions. Investigation of Latency (time from diagnosis to first progression), progression free survival (PFS) and overall survival (OS) were analyzed based on factors such as TP53 mutation, cytogenetics, IGHV mutation, CD38, presence of Diabetes and/or use of metformin at the time of first line treatment, Charlson Comorbidity Index (CCI) and age-adjusted comorbidity index (AACI). Results: Metformin at the time of first line treatment was not associated with improved latency or OS compared to patients who were not diabetic, or were diabetic and were on other agents. Presence of TP53 mutation at the time of diagnosis was associated with a trend to shorter latency and OS, although this did not reach statistical significance. IGHV mutation > 2% and CD38 < 30% were both associated with improved OS (Mean OS 7312 vs. 4084 days with p = 0.036 and Mean OS 5577 vs 4810 days with p = 0.018 respectively). Individual cytogenetic changes (del11q, del17p, normal, +12, del13q) at the time of each progression were not associated with significant differences in PFS. There was no significant difference in PFS1 and OS comparing chemotherapy to newer agents, as well as comparing individual chemotherapy regimens. When stratified based on CCI and AACI groups, there was a statistical difference in OS with higher CCI and AACI groups having worse OS. Conclusions: Use of Metformin was not associated with improvements in latency, or OS. The AACI appears to be a good tool for risk stratification among CLL patients at the time of diagnosis.