Effects  of metformin extended release compared to immediate release formula on glycemic control and glycemic variability in patients with type 2 diabetes

Derosa, Giuseppe; D’Angelo, Angela; Romano, Davide; Maffioli, Pamela

doi:10.2147/dddt.s131670

Cited by 36 publications

(40 citation statements)

References 17 publications

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“…This feature helps to provide slower, smoother, and longer gastric residence time of metformin 500 mg PR tablet, without an initial rapid rise in plasma metformin (GelShield diffusion system). The results of this study were in agreement with the published literature in reporting fewer GI side effects with the use of once-daily metformin PR formulation than that of immediate-release metformin 21,22…”

Section: Discussionsupporting

confidence: 91%

<p>Adherence, satisfaction, and experience with metformin 500 mg prolonged release formulation in Indian patients with type 2 diabetes mellitus: a postmarketing observational study</p>

Kmp¹,

Chawla²,

Sanghvi³

et al. 2019

IJGM

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Purpose The aim of this study was to understand patient adherence, satisfaction, and experience with the smaller sized metformin 500 mg prolonged release (PR) tablet that has been manufactured with the help of technological advancement (Gluformin I 500 mg), in comparison with metformin 500 mg extended-release (ER) tablet, in patients with type 2 diabetes mellitus (T2DM). Patients and methods In this postmarketing observational study, T2DM patients who were on a stable dose of metformin 500 mg PR tablet for at least 1 month and had previously received metformin 500 mg ER tablet were recruited from 50 sites in India. The medication adherence and patients’ experience, satisfaction, and perception with metformin 500 mg PR tablets were compared with metformin 500 mg ER tablets. The patients’ experience was determined based on the external appearance of tablet, ease of swallowing, the presence of gastrointestinal discomfort, and ghost pill effect. Results A total of 1,000 patients were enrolled. The majority had medium adherence to metformin 500 mg PR tablet (54%) and did not report swallowing difficulties (66.2%) due to its small size (64.4%) and oval shape (64.3%). The PR formulation of metformin was more acceptable than ER formulation due to no aftertaste (63%). The ghost pill effect was reported in 0.7% of patients with metformin 500 mg PR tablet against 8.5% with ER tablet. More than 60% of patients were “comfortable” (67.9%), had “much effect on their well-being” (61.8%), and were “satisfied” (69%) with metformin 500 mg PR tablet compared with ER tablet. Patient’s dissatisfaction (42.7%) and taste (24.9%) were the common reasons cited by physicians and patients, respectively, for changing the treatment from metformin 500 mg ER to metformin 500 mg PR formulation. A total of 10 adverse events (nonserious) were reported, and all of them were resolved. Conclusion The technologically advanced formulation of metformin 500 mg PR tablets is more effective than that of metformin 500 mg ER tablets in improving adherence, compliance, satisfaction, and perception to medication in Indian patients with T2DM.

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Section: Discussionsupporting

confidence: 91%

<p>Adherence, satisfaction, and experience with metformin 500 mg prolonged release formulation in Indian patients with type 2 diabetes mellitus: a postmarketing observational study</p>

Kmp¹,

Chawla²,

Sanghvi³

et al. 2019

IJGM

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“…The extended-release form of metformin appeared to reduce weight and inflammation, with fewer side effects than the immediate-release metformin in diabetic people [ 82 ], representing a promising avenue in nondiabetic PWH. The duration and optimal metformin dosage will have to be defined before implementing a large randomized controlled trial.…”

Section: Discussionmentioning

confidence: 99%

Repurposing Metformin in Nondiabetic People With HIV: Influence on Weight and Gut Microbiota

Isnard

Lin

Fombuena

et al. 2020

Open Forum Infectious Diseases

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Background People living with HIV (PLWH) taking antiretroviral therapy (ART) may experience weight gain, dyslipidemia, increased risk of non-AIDS comorbidities and long-term alteration of the gut microbiota. Both low CD4/CD8 ratio and chronic inflammation have been associated with changes in the gut microbiota of PLWH. The anti-diabetic drug metformin has been shown to improve gut microbiota composition while decreasing weight and inflammation in diabetes and polycystic ovary syndrome. Nevertheless, it remains unknown whether metformin may benefit PLWH receiving ART, especially those with low CD4/CD8 ratio. Methods In the Lilac pilot trial, we recruited 23 non-diabetic PLWH receiving ART for more than 2 years with a low CD4/CD8 ratio (<0.7). Blood and stool samples were collected during study visits at baseline, after a 12-week metformin treatment, and 12 weeks after discontinuation. Microbiota composition was analyzed by 16S rDNA gene sequencing and markers of inflammation were assessed in plasma. Results Metformin decreased PLWH weight and weight loss was inversely correlated with plasma levels of the satiety factor GDF-15. Furthermore, metformin changed the gut microbiota composition by increasing the abundance of anti-inflammatory bacteria such as butyrate-producing species and the protective Akkermansia muciniphila. Conclusions Our study provides the first evidence that a 12-week metformin treatment decreased weight and favoured anti-inflammatory bacteria abundance in the microbiota of non-diabetic ART-treated PLWH. A larger randomized, placebo controlled clinical trials with longer metformin treatment will be needed to further investigate the role of metformin in reducing inflammation and the risk of non-AIDS comorbidities in ART-treated PLWH.

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“…One randomized clinical trial studied the effects of metformin immediate release compared with metformin extended release on glycemic control in type 2 diabetes mellitus (T2DM) [ 118 ]. The authors observed increased levels of visfatin in patients randomized to metformin extended release [ 118 ]. Another trial showed a reduction in visfatin serum levels after metformin administration in PCOS women [ 119 ].…”

Section: Relevance Of Visfatin To Metabolic Diseasesmentioning

confidence: 99%

Visfatin: A Possible Role in Cardiovasculo-Metabolic Disorders

Dakroub

Nasser

Younis

et al. 2020

Cells

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Visfatin/NAMPT (nicotinamide phosphoribosyltransferase) is an adipocytokine with several intriguing properties. It was first identified as pre-B-cell colony-enhancing factor but turned out to possess enzymatic functions in nicotinamide adenine dinucleotide biosynthesis, with ubiquitous expression in skeletal muscles, liver, cardiomyocytes, and brain cells. Visfatin exists in an intracellular (iNAMPT) and extracellular (eNAMPT) form. Intracellularly, visfatin/iNAMPT plays a regulatory role in NAD+ biosynthesis and thereby affects many NAD-dependent proteins such as sirtuins, PARPs, MARTs and CD38/157. Extracellularly, visfatin is associated with many hormone-like signaling pathways and activates some intracellular signaling cascades. Importantly, eNAMPT has been associated with several metabolic disorders including obesity and type 1 and 2 diabetes. In this review, a brief overview about visfatin is presented with special emphasis on its relevance to metabolic diseases. Visfatin/NAMPT appears to be a unique molecule with clinical significance with a prospective promising diagnostic, prognostic, and therapeutic applications in many cardiovasculo-metabolic disorders.

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Effects of metformin extended release compared to immediate release formula on glycemic control and glycemic variability in patients with type 2 diabetes

Cited by 36 publications

References 17 publications

<p>Adherence, satisfaction, and experience with metformin 500 mg prolonged release formulation in Indian patients with type 2 diabetes mellitus: a postmarketing observational study</p>

<p>Adherence, satisfaction, and experience with metformin 500 mg prolonged release formulation in Indian patients with type 2 diabetes mellitus: a postmarketing observational study</p>

Repurposing Metformin in Nondiabetic People With HIV: Influence on Weight and Gut Microbiota

Visfatin: A Possible Role in Cardiovasculo-Metabolic Disorders

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