Metformin and β‐cell function in insulin‐treated patients with type 2 diabetes: A randomized placebo‐controlled 4.3‐year trial

Top, Wiebe M C; Stehouwer, Coen D. A.; Lehert, Philippe; Kooy, Adriaan

doi:10.1111/dom.13123

Cited by 7 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Gastric banding (20)(21)(22) and metformin (23,24) have been shown to improve insulin sensitivity, b-cell function, and glycemia in people with fully developed T2D. In people with IGT or early, mild T2D, we observed no improvement in b-cell function and only modest improvements in glycemia despite large improvements in insulin sensitivity.…”

Section: Discussioncontrasting

confidence: 49%

Impact of Gastric Banding Versus Metformin on β-Cell Function in Adults With Impaired Glucose Tolerance or Mild Type 2 Diabetes

et al. 2018

View full text Add to dashboard Cite

OBJECTIVEType 2 diabetes (T2D) results from progressive loss of b-cell function. The BetaFat study compared gastric banding and metformin for their impact on b-cell function in adults with moderate obesity and impaired glucose tolerance (IGT) or recently diagnosed, mild T2D. RESEARCH DESIGN AND METHODSEighty-eight people aged 21-65 years, BMI 30-40 kg/m 2 , with IGT or diabetes known for <1 year, were randomized to gastric banding or metformin for 2 years. Hyperglycemic clamps (11.1 mmol/L) followed by arginine injection at maximally potentiating glycemia (>25 mmol/L) were performed at baseline, 12 months, and 24 months to measure steady-state C-peptide (SSCP) and acute C-peptide response to arginine at maximum glycemic potentiation (ACPRmax) and insulin sensitivity (M/I). RESULTSAt 24 months, the band group lost 10.7 kg; the metformin group lost 1.7 kg (P < 0.01). Insulin sensitivity increased 45% in the band group and 25% in the metformin group (P = 0.30 between groups). SSCP adjusted for insulin sensitivity fell slightly but not significantly in each group (P = 0.34 between groups). ACPRmax adjusted for insulin sensitivity fell significantly in the metformin group (P = 0.002) but not in the band group (P = 0.25 between groups). HbA 1c fell at 12 and 24 months in the band group (P < 0.004) but only at 12 months (P < 0.01) in the metformin group (P > 0.14 between groups). Normoglycemia was present in 22% and 15% of band and metformin groups, respectively, at 24 months (P = 0.66 between groups). CONCLUSIONSGastric banding and metformin had similar effects to preserve b-cell function and stabilize or improve glycemia over a 2-year period in moderately obese adults with IGT or recently diagnosed, mild T2D.Type 2 diabetes (T2D) generally results from a progressive loss of b-cell compensation for chronic insulin resistance, an important measure of b-cell function. There is very strong cross-sectional (1) and longitudinal (2-4) evidence that b-cell compensation declines for years before the development of diabetes, often reaching ,50% of normal in people with impaired glucose tolerance (IGT) or early diabetes. This

show abstract

Section: Discussioncontrasting

confidence: 49%

Impact of Gastric Banding Versus Metformin on β-Cell Function in Adults With Impaired Glucose Tolerance or Mild Type 2 Diabetes

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In secondary analyses, we also assessed the alternative hypothesis of a treatment effect from the first visit and remaining constant until the end of the trial [10] by assuming placebo effects at baseline and testing the treatment main effect. Also, we adjusted for eGFR and body mass index as additional covariates in the primary model.…”

Section: Discussionmentioning

confidence: 99%

Metformin and N-terminal pro B-type natriuretic peptide in type 2 diabetes patients, a post-hoc analysis of a randomized controlled trial

Top

Lehert²,

Schalkwijk

et al. 2021

PLoS ONE

Self Cite

View full text Add to dashboard Cite

Background Beyond antihyperglycemic effects, metformin may improve cardiovascular outcomes. Patients with type 2 diabetes often have an elevated plasma level of N-terminal pro B-type as a marker of (sub) clinical cardiovascular disease. We studied whether metformin was associated with a reduction in the serum level of N-terminal pro B-type natriuretic peptide (NT-proBNP) in these patients. Methods In the HOME trial 390 insulin-treated patients with type 2 diabetes were randomized to 850 mg metformin or placebo three times daily. Plasma samples were drawn at baseline, 4, 17, 30, 43 and 52 months. In a post-hoc analysis we analyzed the change in NT-proBNP in both groups. We used a longitudinal mixed model analysis adjusting for age, sex and prior cardiovascular disease. In a secondary analysis we assessed a possible immediate treatment effect post baseline. Results Metformin did not affect NT-proBNP levels over time in the primary analysis (-1% [95%CI -4;3, p = 0.62]). In the secondary analysis there was also no sustained time independent immediate treatment effect (initial increase of 17% [95%CI 4;30, p = 0.006] followed by yearly decrease of -4% [95%CI -7;0, p = 0.07]). Conclusions Metformin as compared to placebo did not affect NT-proBNP plasma levels in this 4.3-year placebo-controlled trial. Potential cardioprotective effects of metformin cannot be explained by changes in cardiac pressures or volumes to the extent reflected by NT-proBNP.

show abstract

Section: Interventions Obes Diabetesmentioning

confidence: 99%

“…One study has shown that metformin can restore the intracellular abnormalities of glucose and FFA metabolism and to restore a normal secretory pattern in rat pancreatic islets especially for those whose secretory function has been impaired by chronic exposure to elevated FFA or glucose levels [3,4]. Another study of 390 insulin-treated patients with type 2 diabetes were randomized to either placebo or metformin found that Fasting C Peptide-to-Glucose Ratio (FCPGR) increased in the metformin group with 1.48 (95% CI, 1.09-1.87, P<0.00) and thus improves long-term estimates of beta cell function in the fasting state [5]. These data might give hope that metformin has potential effect in preserving beta cell function in patients with prediabetic as well as diabetic mellitus.…”

Section: Preserve Beta Cell Functionmentioning

confidence: 99%

The Effect of Metformin in Treating Prediabetic Patients

Kalbani

2022

IOD

View full text Add to dashboard Cite

Prediabetic is a state when the blood sugar level is high but not reaching the diagnostic status of diabetes mellitus. As defined by American Diabetic Association (ADA), it includes impaired fasting glucose (FBS 5.6-6.9mmol/L) and/or impaired glucose tolerance (glucose 7.8-11.0mmol/L, 2 hours after ingestion of a 75-g oral glucose load) and/or HbA1c 5.7-6.4%. The risk of progressing to diabetes is greater in patient with both IFG and IGT compared with isolated IFG or isolated IGT alone [1,2]. Although patients with prediabetes are asymptomatic, but they carry comparable macrovascular complication and retinopathy like diabetes mellitus. The progression to type 2 DM may vary from one individual to another depend on degree of insulin deficiency/resistance along with other risk factors. Several risk factors have been contributing to the development of prediabetes and it is almost like that factor related to development of type 2DM. These include increasing age, physical inactivity, obesity (BMI>=30KG/M 2 ), family history of DM 2, High risk ethnic groups and past history of GDM and PCOS. Several approaches have been tried to manage prediabetic status to delay and/or prevent the progression to DM2 including pharmacological approach and lifestyle management. This article will give an overview about the use of metformin as a treatment of prediabetes.

show abstract

Metformin and β‐cell function in insulin‐treated patients with type 2 diabetes: A randomized placebo‐controlled 4.3‐year trial

Cited by 7 publications

References 14 publications

Impact of Gastric Banding Versus Metformin on β-Cell Function in Adults With Impaired Glucose Tolerance or Mild Type 2 Diabetes

Impact of Gastric Banding Versus Metformin on β-Cell Function in Adults With Impaired Glucose Tolerance or Mild Type 2 Diabetes

Metformin and N-terminal pro B-type natriuretic peptide in type 2 diabetes patients, a post-hoc analysis of a randomized controlled trial

The Effect of Metformin in Treating Prediabetic Patients

Contact Info

Product

Resources

About