Metformin in the Treatment of HIV Lipodystrophy Syndrome

Hadigan, Colleen; Corcoran, Colleen; Basgoz, Nesli; Davis, Benjamin; Sax, Paul E.; Grinspoon, Steven

doi:10.1001/jama.284.4.472

Cited by 334 publications

(178 citation statements)

References 25 publications

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“…in HIV-infected patients modeled after the DPP, do suggest reductions in HbA1c over 6 months (60). Insulin sensitizing agents may be useful to reduce insulin resistance and may also help to reduce central fat accumulation (67) or even to increase peripheral fat in some lipoatrophic insulin resistant patients (68), but should not be used for the sole purpose of improving body composition. Moreover, the risk profile of these drugs may be great, with the potential for interaction with ART.…”

Section: Prevention Strategies For Chd In Hiv-infected Patientsmentioning

confidence: 99%

State of the Science Conference

Grinspoon¹,

Grünfeld²,

Kotler³

et al. 2008

Circulation

192

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Section: Prevention Strategies For Chd In Hiv-infected Patientsmentioning

confidence: 99%

State of the Science Conference

Grinspoon¹,

Grünfeld²,

Kotler³

et al. 2008

Circulation

192

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“…Several studies have affirmed the value of metformin to slow or prevent progression of impaired glucose tolerance (IGT)/impaired fasting glucose (IFG) ('prediabetes') to type 2 diabetes and other studies have suggested a place for metformin in the [84][85][86][87]. Reduced cancer risk was tentatively indicated in the UKPDS and has subsequently been identified in large database analyses, suggesting that metformin might protect against certain cancers in individuals with type 2 diabetes, notably in the bowel where drug exposure is high, and this has opened a whole new research arena [69,88,89].…”

Section: Other Indicationsmentioning

confidence: 99%

Metformin: historical overview

2017

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Metformin (dimethylbiguanide) has become the preferred first-line oral blood glucose-lowering agent to manage type 2 diabetes. Its history is linked to Galega officinalis (also known as goat's rue), a traditional herbal medicine in Europe, found to be rich in guanidine, which, in 1918, was shown to lower blood glucose. Guanidine derivatives, including metformin, were synthesised and some (not metformin) were used to treat diabetes in the 1920s and 1930s but were discontinued due to toxicity and the increased availability of insulin. Metformin was rediscovered in the search for antimalarial agents in the 1940s and, during clinical tests, proved useful to treat influenza when it sometimes lowered blood glucose. This property was pursued by the French physician Jean Sterne, who first reported the use of metformin to treat diabetes in 1957. However, metformin received limited attention as it was less potent than other glucose-lowering biguanides (phenformin and buformin), which were generally discontinued in the late 1970s due to high risk of lactic acidosis. Metformin's future was precarious, its reputation tarnished by association with other biguanides despite evident differences. The ability of metformin to counter insulin resistance and address adult-onset hyperglycaemia without weight gain or increased risk of hypoglycaemia gradually gathered credence in Europe, and after intensive scrutiny metformin was introduced into the USA in 1995. Long-term cardiovascular benefits of metformin were identified by the UK Prospective Diabetes Study (UKPDS) in 1998, providing a new rationale to adopt metformin as initial therapy to manage hyperglycaemia in type 2 diabetes. Sixty years after its introduction in diabetes treatment, metformin has become the most prescribed glucose-lowering medicine worldwide with the potential for further therapeutic applications.

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“…42 Hadigan et al demonstrated a 6-fold increase risk of impaired glucose tolerance among HIV-infected patients with clinical and subjective evidence of fat redistribution compared to age and BMI-matched subjects from the Framingham Offspring Cohort (30 vs 5%). Subjects with abnormal fat redistribution also had an increased prevalence of diabetes mellitus (8% vs. 0.5%) compared to the Framingham subjects 43 . The insulin resistance demonstrated in HIV patients is considered by most authors to confer a high risk of coronary artery disease (CAD) in these subjects.…”

Section: Metabolic Disorders Pancreatic Dysfunction and Glucose Metabmentioning

confidence: 90%

Endocrine and Metabolic Disorders Associated with Human Immune Deficiency Virus Infection

Unachukwu¹,

Uchenna²,

Young³

2009

West African Journal of Medicine

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RÉSUMÉ CONTEXTE: De nombreux rapports ont décrit endocriniens et métaboliques troubles dans le virus de l'immunodéficience humaine (VIH). Cet article a passé en revue différents rapports dans la littérature afin d'accroître la sensibilisation et donc la nécessité d'une intervention précoce en cas de besoin. SOURCE DES DONNÉES: Les données ont été obtenues à partir de MEDLINE, de recherche Google et d'autres revues sur le VIH, endocrinopathies / Troubles métaboliques "de 1985 à 2007. ÉTUDE DE SÉLECTION: Les études relatives au VIH associés endocrinopathies et les maladies métaboliques au cours des deux dernières décennies ont été examinés. L'extraction de données: Informations sur l'épidémiologie, la pathogenèse, le diagnostic et le traitement de l'organe cible endocrinopathies et les maladies métaboliques dans le domaine du

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Metformin in the Treatment of HIV Lipodystrophy Syndrome

Abstract: This study suggests that a relatively low dosage of metformin reduces insulin resistance and related cardiovascular risk parameters in HIV-infected patients with lipodystrophy. JAMA. 2000;284:472-477

Cited by 334 publications

References 25 publications

State of the Science Conference

State of the Science Conference

Metformin: historical overview

Endocrine and Metabolic Disorders Associated with Human Immune Deficiency Virus Infection

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