Safety, tolerability, and efficacy of metformin extended‐release oral antidiabetic therapy in patients with type 2 diabetes: An observational trial in Asia

Abstract

BackgroundThe aim of the present prospective observational study was to assess the tolerability and antihyperglycemic efficacy of metformin extended-release (MXR) in the routine treatment of patients with type 2 diabetes mellitus (T2DM) from six Asian countries.MethodsData from 3556 patients treated with once-daily MXR for 12 weeks, or until discontinuation, were analyzed.ResultsTreatment with MXR was well tolerated, with 97.4% of patients completing 12 weeks of treatment. Only 3.3% of patients experienced one or more gastrointestinal (GI) side-effects and only 0.7% of patients discontinued for this reason (primary endpoint). The incidence of GI side-effects and related discontinuations appeared to be considerably lower during short-term MXR therapy than during previous treatment (mean 2.71 years’ duration), most commonly with immediate-release metformin. A 12-week course of MXR therapy also reduced HbA1c and fasting glucose levels from baseline.ConclusionsThe present study provides new insights into the incidence of GI side-effects with MXR in Asian patients with T2DM and on the tolerability of MXR in non-Caucasian populations. Specifically, these data indicate that once-daily MXR not only improves measures of glycemic control in Asian patients with T2DM, but also has a favorable GI tolerability profile that may help promote enhanced adherence to oral antidiabetic therapy.

Ethnic Similarities and Differences in the Relationship between Beta Cell Mass and Diabetes

“…Lifestyle modification such as nutritional therapy, exercise, and weight loss remains the essential factor of treatment of T2DM at any stage of the disease including IGT. Since metformin is effective not only in obese patients but also in lean patients with T2DM [ 42 ], and reduces insulin demand by lowering hepatic glucose production, starting therapy by metformin in addition to lifestyle modification should be considered as early a stage of diabetes as possible in patients without contraindication. The use of incretin therapy, which enhances physiological insulin secretion without serious adverse effects, is now widely used for treatment of T2DM.…”

Severity of gastrointestinal side effects of metformin tablet compared to metformin capsule in type 2 diabetes mellitus patients

“…[1014] However, it was reported that some patients may discontinue therapy due to the higher medication costs. The disintegration time for HGCs is about 15 min.…”

Practical combination therapy based on pathophysiology of type 2 diabetes

“…However, because metformin primarily relies on renal function for elimination,72 it is contraindicated in patients with renal disease or dysfunction 73. Metformin is also associated with gastrointestinal adverse effects that may lead to discontinuation for some patients but may dissipate with continued use or with dosing adjustments 74. TZDs have been shown to have beneficial effects on cognitive disorders related to insulin resistance in the central nervous system in studies in mice75 and to exert favorable effects on cardiovascular (CV) risk markers in patients with T2D 76.…”