Clinical Characteristics Influencing the Effectiveness of Metformin on Japanese Type 2 Diabetes Receiving Sulfonylureas

Tomioka, Setsuko; Ogata, Hiroyasu; Tamura, Yasuaki; Shimizu, Tomoaki; Watada, Hirotaka; Fujitani, Yoshio; Kawamori, Ryuzo; Hirose, Takahisa

doi:10.1507/endocrj.k06-162

Cited by 7 publications

(2 citation statements)

References 29 publications

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“…There was no significant relationship between the rate of decrease in HbA1c and baseline BMI or HOMA2-IR indicating insulin resistance, which was similar to that reported in Asian studies [22,[34][35][36]. This drug is widely used in patients with T2D, who are mainly obese and insulin-resistant.…”

Section: Effect Of Metformin In Patients With Decreased Insulin Secre...supporting

confidence: 84%

The METRO study: a retrospective analysis of the efficacy of metformin for type 2 diabetes in Japan

Harada

Kondo²,

Sugiyama

et al. 2023

Endocr J

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Metformin monotherapy as first-line treatment for patients with type 2 diabetes (T2D) has been shown to effectively improve blood glucose levels and motivation to undergo treatment and prevent complications. However, no studies have reported its effect when combined with other drugs or compared the effect based on administration time. This study aimed to investigate the effect of metformin administration in Japanese patients with T2D, examine how the introduction line impacts the effect of metformin, and examine the characteristics of patients demonstrating improved blood glucose levels. Data on characteristics of patients who were newly prescribed metformin with no shifting of hypoglycemic agents in the subsequent 24-week observation period, and their age [mean, 56.8 years], body mass index [mean, 27.5 kg/m 2 ], glycated hemoglobin [HbA1c] [mean, 8.1%], and duration of diabetes [mean, 3.0 years] were obtained from the medical records of 201 patients. The changes in HbA1c by introduction line after 24 weeks were -1.59%, -0.91%, -0.89%, and -0.65% in the first, second, third, and fourth induction lines, respectively; earlier introduction more significantly improved blood glucose. The factors significantly associated with HbA1c changes were early introduction, high baseline HbA1c, high estimated glomerular filtration rate, decreased insulin secretion, short estimated duration of diabetes, and increased metformin dose. Furthermore, factors contributing to the largest HbA1c improvement by metformin were high baseline HbA1c and early administration. Metformin is expected to lower blood glucose levels in Japanese patients with T2D, even in those with decreased insulin secretion, due to its early introduction as a first-line drug.

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Section: Effect Of Metformin In Patients With Decreased Insulin Secre...supporting

confidence: 84%

The METRO study: a retrospective analysis of the efficacy of metformin for type 2 diabetes in Japan

Harada

Kondo²,

Sugiyama

et al. 2023

Endocr J

View full text Add to dashboard Cite

show abstract

“…But we also know that there are nonresponders to any drug. Numerous post hoc studies have revealed some predictors of better responses, but the data are inconclusive (57–60). Furthermore, those response differences tend to be small, and the strongest predictor remains baseline A1C, with the patients with higher A1C levels responding with greater reductions although not necessarily attaining target levels (58,61).…”

Section: State Of the Art For Personalizing Medicinementioning

confidence: 99%

Personalized Management of Hyperglycemia in Type 2 Diabetes

et al. 2013

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In June 2012, 13 thought leaders convened in a Diabetes Care Editors’ Expert Forum to discuss the concept of personalized medicine in the wake of a recently published American Diabetes Association/European Association for the Study of Diabetes position statement calling for a patient-centered approach to hyperglycemia management in type 2 diabetes. This article, an outgrowth of that forum, offers a clinical translation of the underlying issues that need to be considered for effectively personalizing diabetes care. The medical management of type 2 diabetes has become increasingly complex, and its complications remain a great burden to individual patients and the larger society. The burgeoning armamentarium of pharmacological agents for hyperglycemia management should aid clinicians in providing early treatment to delay or prevent these complications. However, trial evidence is limited for the optimal use of these agents, especially in dual or triple combinations. In the distant future, genotyping and testing for metabolomic markers may help us to better phenotype patients and predict their responses to antihyperglycemic drugs. For now, a personalized (“n of 1”) approach in which drugs are tested in a trial-and-error manner in each patient may be the most practical strategy for achieving therapeutic targets. Patient-centered care and standardized algorithmic management are conflicting approaches, but they can be made more compatible by recognizing instances in which personalized A1C targets are warranted and clinical circumstances that may call for comanagement by primary care and specialty clinicians.

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Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus

Salpeter

Greyber

Pasternak

et al. 2010

Cochrane Database of Systematic Reviews

297

144

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Clinical Characteristics Influencing the Effectiveness of Metformin on Japanese Type 2 Diabetes Receiving Sulfonylureas

Cited by 7 publications

References 29 publications

The METRO study: a retrospective analysis of the efficacy of metformin for type 2 diabetes in Japan

The METRO study: a retrospective analysis of the efficacy of metformin for type 2 diabetes in Japan

Personalized Management of Hyperglycemia in Type 2 Diabetes

Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus

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