Effect of metformin on patients with impaired glucose tolerance

Li, C. L.; Pan, Changyu; Lu, Juming; Zhu, Yating; Wang, J. H.; Deng, Xinrui; Xia, Fang; Wang, H. Z.

doi:10.1046/j.1464-5491.1999.00090.x

Cited by 82 publications

(69 citation statements)

References 15 publications

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“…The beneficial changes were similar to those observed with LSC and also showed that the combination of LSC with metformin did not have an additional benefit (Ramachandran et al, 2006). A Chinese study randomizing 70 participants with IGT to receive placebo and metformin at a dosage of 250 mg 3 times a day for a period of 12 months and observed a beneficial effect of metformin in reducing diabetes incidence in comparison to placebo (Met: 16.2% vs. Pbo: 3%) (Li et al, 1999). A meta-analysis of 31 randomized studies including 4570 participants of at least 8 weeks of metformin use showed that the incidence of DM2 was reduced by 40% with an absolute risk reduction of 6% (Sally, 2008).…”

Section: Metforminsupporting

confidence: 56%

Prevention of Diabetes: Effects of a Lifestyle Intervention

McLellan¹,

Lerário²,

Burini³

2011

Topics in the Prevention, Treatment and Complications of Type 2 Diabetes

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Section: Metforminsupporting

confidence: 56%

Prevention of Diabetes: Effects of a Lifestyle Intervention

McLellan¹,

Lerário²,

Burini³

2011

Topics in the Prevention, Treatment and Complications of Type 2 Diabetes

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“…The mechanism for metformin's effect seems to involve improved signaling through both AMPK and the insulin signaling pathway in the liver. These findings may help in explaining the prophylactic effect of metformin to oppose further deterioration in glucoregulation in humans with impaired glucose tolerance or obesity (29,30) and in implicating enhanced liver signaling in the therapeutic mechanism of action of metformin.…”

Section: Discussionmentioning

confidence: 99%

Metformin Prevents the Development of Acute Lipid-Induced Insulin Resistance in the Rat Through Altered Hepatic Signaling Mechanisms

et al. 2004

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Metformin reduces the incidence of progression to type 2 diabetes in humans with obesity or impaired glucose tolerance. We used an animal model to investigate whether metformin could prevent acute lipid-induced insulin resistance and the mechanisms involved. Metformin or vehicle was administered to rats daily for 1 week. Rats were studied basally, after 3.75 h of intralipid-heparin or glycerol infusion, or after 5 h of infusion with a hyperinsulinemic-euglycemic clamp between 3 and 5 h. Metformin had no effect on plasma triacylglycerol or nonesterified fatty acid concentrations and did not alter glucose turnover or gluconeogenic enzyme mRNA after lipid infusion. However, metformin normalized hepatic glucose output and increased liver glycogen during lipid infusion and clamp. Basal liver (but not muscle or fat) AMP-activated protein kinase activity was increased by metformin (by 310%; P < 0.01), associated with increased phosphorylation of acetyl CoA carboxylase. Postclamp liver but not muscle phosphorylated/total Akt protein was increased, whereas basal c-Jun NH 2 -terminal kinase-1 and -2 protein expression were reduced (by 39 and 53%, respectively; P < 0.05). Metformin also increased hepatic basal IB␣ levels (by 260%; P < 0.001) but had no effect on tyrosine phosphorylation or expression of insulin receptor substrate-1 (IRS-1). In summary, metformin opposes the development of acute lipid-induced insulin resistance in the liver through alterations in multiple signaling pathways. Diabetes 53:3258 -3266, 2004

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“…The remaining biguanide studies found no significant reduction in the incidence of diabetes compared with placebo using intention-to-treat analyses (13)(14)(15)(16)(17). All of these studies had very low diabetes incidence rates and were likely underpowered.…”

Section: Oral Hypoglycemic Agentsmentioning

confidence: 99%

A Systematic Review of Drug Therapy to Delay or Prevent Type 2 Diabetes

Padwal

Majumdar²,

Johnson³

et al. 2005

Diabetes Care

141

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OBJECTIVE -To systematically review the evidence for the prevention of type 2 diabetes by pharmacological therapies.RESEARCH DESIGN AND METHODS -Randomized controlled trials and cohort studies examining the effect of oral hypoglycemic agents, antiobesity agents, antihypertensive agents, statins, fibrates, and estrogen on the incidence of type 2 diabetes were identified from MEDLINE, EMBASE, the Cochrane Controlled Trials Registry, and searches of reference lists. Two reviewers independently assessed studies for inclusion and performed data extraction.RESULTS -Ten studies of oral hypoglycemic agents and 15 studies of nonoral hypoglycemic agents were found. Oral hypoglycemic agents and orlistat are the only drugs that have been studied in randomized controlled trials with diabetes incidence as the primary end point. In the largest studies of 2.5-4.0 years' duration, metformin (relative risk [RR] 0.69, 95% CI 0.57-0.83), acarbose (0.75, 0.63-0.90), troglitazone (0.45, 0.25-0.83), and orlistat (hazard ratio [HR] 0.63, 95% CI 0.46 -0.86) have all been shown to decrease diabetes incidence compared with placebo; however, follow-up rates varied from 43 to 96%. Current evidence for statins, fibrates, antihypertensive agents, and estrogen is inconclusive. In addition, the critical question of whether drugs are preventing, or simply delaying, onset of diabetes remains unresolved.CONCLUSIONS -Currently, no single agent can be definitively recommended for diabetes prevention. Future studies should be designed with diabetes incidence as the primary outcome and should be of sufficient duration to differentiate between genuine diabetes prevention as opposed to simple delay or masking of this condition. Diabetes Care 28:736 -744, 2005

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Effect of metformin on patients with impaired glucose tolerance

Abstract: Metformin can improve glucose metabolism in IGT patients and may be a treatment option in their management of IGT subjects.

Cited by 82 publications

References 15 publications

Prevention of Diabetes: Effects of a Lifestyle Intervention

Prevention of Diabetes: Effects of a Lifestyle Intervention

Metformin Prevents the Development of Acute Lipid-Induced Insulin Resistance in the Rat Through Altered Hepatic Signaling Mechanisms

A Systematic Review of Drug Therapy to Delay or Prevent Type 2 Diabetes

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