Long-term effect of metformin on blood glucose control in non-obese patients with type 2 diabetes mellitus

Abstract

BackgroundWe aimed to investigate the long-term effect of metformin on the blood glucose control in non-obese patients with type 2 diabetes mellitus.MethodsA retrospective study was performed in 213 patients with type 2 diabetes mellitus under the administration of metformin for more than one year. The clinical parameters were investigated for 3 years. The obese and non-obese individuals were defined as a body mass index (BMI) of 25 kg/m2 or over (n = 105) and a BMI of less than 25 kg/m2 (n = 108), respectively.ResultsHbA1c levels were significantly decreased compared with those at the baseline time. The course of HbA1c was similar between the non-obese and the obese groups, while the dose of metformin required to control blood glucose was significantly lower in the non-obese group than in the obese group. The reductions in HbA1c were 1.2% and 1.1% at 12 months, 0.9% and 0.9% at 24 months, and 0.8% and 1.0% at 36 months in the non-obese and obese groups, respectively. BMI did not change during the observation periods. Approximately half of all patients required no additional antidiabetic agents or a reduction in other treatments after the initiation of metformin in either of the two groups.ConclusionsThe present study demonstrated the long-term beneficial effect of metformin in non-obese (BMI < 25 kg/m2) diabetic patients. This effect appears to be maintained even after the observation period of this study, because metformin was limited to a relatively low dose in the non-obese group and the observed worsening in glycemic control over time can probably be attenuated by increasing the dose of metformin.

Impact of Baseline BMI on Glycemic Control and Weight Change with Metformin Monotherapy in Chinese Type 2 Diabetes Patients: Phase IV Open-Label Trial

“…Our findings are in good agreement with those of previous prospective [14] and retrospective [12], [13], [16] studies of metformin that show similar efficacy between obese and non-obese type 2 diabetes patients, although our study has the lowest cut-off point for defining overweight patients (i.e. BMI ≥24 kg/m 2 ).…”

“…BMI ≥24 kg/m 2 ). In two studies that defined normal-weight patients as BMI <25 kg/m 2 and overweight patients as BMI ≥25 kg/m 2 , HbA 1c was reduced by 1.46% [13] and 1.2% [16] in the normal-weight patients, and by 1.34% and 1.1% in the overweight patients, respectively, after 3–12 months of metformin treatment. Even after 12 months of treatment, no reduction in BMI was observed in the normal-weight cohort in the Japanese study [16].…”

“…However, most of these were retrospective or observational studies, involved mainly Caucasians, and ‘non-obesity’ was defined as BMI <27 kg/m 2 [14], <28 kg/m 2 [15], or <30 kg/m 2 [12]. Another retrospective study in Japanese type 2 diabetes patients showed that metformin had similar effects on glycosylated hemoglobin (HbA 1c ) levels in obese (defined as BMI ≥25 kg/m 2 ) and non-obese (BMI <25 kg/m 2 ) patients, with no significant differences in BMI change between study groups [16].…”

The Magnitude of Weight Loss Induced by Metformin is Independently Associated with BMI at Baseline in Newly Diagnosed Type 2 Diabetes: Post-hoc Analysis from Data of a Phase IV Open-labeled Trial

“…[9][10][11][12][13][14][15][16][17] The discrepancy may be ascribed to different ethnicities and characteristics of subjects enrolled in the different studies. The magnitude of weight loss varies slightly among the studies.…”

in vitro Controlled Drug Release of Antidiabetic Metformin HCl from Citric Acid Activated Natural Montmorillonite

“…It has also been shown to be effective in regulating blood sugar levels of type 2 diabetes mellitus patients with obesity. In addition, metformin HCl can protect the cardiovascular system, stabilize weight and improve the patient's survival rate better than sulfonylurea or insulin therapy [1,2]. However, high daily dose of metformin HCl (1.5-3 g/day) must be administrated to the patients because of its low oral bioavaliability (50-60 %) with a half-life of 1.5-1.6 h [3,4].…”