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. 2010 Nov 12:7:83.
doi: 10.1186/1743-7075-7-83.

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

Hiroyuki Ito  1 , Hidenori Ishida, Yuichiro Takeuchi, Shinichi Antoku, Mariko Abe, Mizuo Mifune, Michiko Togane
Affiliations

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

Hiroyuki Ito et al. Nutr Metab (Lond). .

Abstract

Background: We aimed to investigate the long-term effect of metformin on the blood glucose control in non-obese patients with type 2 diabetes mellitus.

Methods: A 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.

Results: HbA1c 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.

Conclusions: The 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.

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Figures

Figure 1
Figure 1
Flow diagram of the population cohort. BMI: body mass index. OHAs: oral hypoglycemic agents.
Figure 2
Figure 2
Changes of HbA1c levels and body mass index in obese and non-obese patients with type 2 diabetes mellitus. Data represent the mean ± SD. Open and closed circles represent the values in obese and non-obese individuals, respectively. * P < 0.05 and ** P < 0.01 vs. 0 M (initiation of metformin). $ P < 0.01 vs. obese.
Figure 3
Figure 3
Changes in the dose of metformin and those corrected by the patient's body weight. Data represent the mean ± SD. Open and closed circles represent the values in obese and non-obese individuals, respectively. * P < 0.05 and ** P < 0.01 vs. 0 M (initiation of metformin). $ P < 0.05 and $$ P < 0.01 vs. obese.
Figure 4
Figure 4
Changes of HbA1c levels among the patient subgroups divided according to therapeutic methods prior to the initiation of metformin in the non-obese (left) and obese (right) patients with type 2 diabetes mellitus. Data represent the mean ± SD. Closed circles, closed squares and open squares represent the diet, oral hypoglycemic agents (OHAs) and insulin therapies, respectively. * P < 0.05 and ** P < 0.01 among three treatment groups.
Figure 5
Figure 5
Changes in HbA1c levels in patients who required no additional antidiabetic agents or a reduction in treatment. Data represent the mean ± SD. Open and closed circles represent the values in obese and non-obese individuals, respectively. * P < 0.05 and ** P < 0.01 vs. 0 M (initiation of metformin).
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