(Journal Article): "Low Dose" Metformin Improves Hyperglycemia Better Than Acarbose in Type 2 Diabetics
Yajima K, Shimada A, Hirose H, Kasuga A, Saruta T (Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan,
asmd(at)st.itc.keio.ac.jp
)
IN:
Rev Diabetic Stud
2004; 1(2):89-94
Impact Factor(s) of Rev Diabetic Stud: 0.125 (2006)
Fulltext:
HTML
PDF
ABSTRACT: OBJECTIVES: "High dose" metformin therapy (2,550 mg/day) is reported to improve glycemic control in type 2 diabetic patients with obesity (body mass index (BMI) >= 30). Some have reported that metformin therapy, even in low doses (500-750 mg/day), improves glycemic control in non-obese type 2 diabetic patients (BMI approximately 25). However, it is unclear whether "low dose" metformin improves glycemic control better than acarbose in non-obese type 2 diabetic patients, which has been shown to improve glycemic control in type 2 diabetes with obesity. METHODS: We randomly divided 22 non-obese type 2 diabetic patients (mean BMI approximately 25) into two groups (A=11, B=11). Group A was treated with "low dose" metformin (500-750 mg/day) for 3 months, and switched to acarbose (150-300 mg/day) for another 3 months. Group B was treated with acarbose first, and then switched to "low dose" metformin. RESULTS: "Low dose" metformin significantly decreased the fasting plasma glucose (FPG) and HbA1c level in both groups A and B, whereas acarbose decreased HbA1c levels in group B but not in group A. Overall, "low dose" metformin significantly decreased HbA1c (p=0.0165) levels as compared to acarbose. CONCLUSION: In conclusion, "low dose" metformin therapy improved glycemic control better than acarbose in non-obese diabetics.
TYPE OF PUBLICATION: Original article
REFERENCES:
- Coniff RF, Shapiro JA, Seaton TB. Long-term efficacy and safety of acarbose in the treatment of obese subjects with non-insulin-dependent diabetes mellitus. Arch Intern Med 1994. 154:2442-2448.
- Feinglos MN, Bethel MA. Oral agent therapy in the treatment of type 2 diabetes. Diabetes Care 1999. 22 Suppl 3:C61-64.
- Wolever TM, Chiasson JL, Josse RG, Hunt JA, Palmason C, Rodger NW, Ross SA, Ryan EA, Tan MH. Small weight loss on long-term acarbose therapy with no change in dietary pattern or nutrient intake of individuals with non-insulin-dependent diabetes. Int J Obes Relat Metab Disord 1997. 21(9):756-763.
- Sangiorgio L, Attardo T, Condorelli L, Lunetta M. Effects of the treatment with acarbose in elderly overweight type 2 diabetic patients in poor glycemic control with oral hypoglycemic agents or insulin. Arch Gerontol Geriatr 2000. 31(1):27-34.
- DeFronzo RA, Goodman AM. Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group. N Engl J Med 1995. 333(9):541-549.
- Davidson MB, Peters AL. An overview of metformin in the treatment of type 2 diabetes mellitus. Am J Med 1997. 102(1):99-110.
- Holman RR, Cull CA, Turner RC. A randomized double-blind trial of acarbose in type 2 diabetes shows improved glycemic control over 3 years (U.K. Prospective Diabetes Study 44). Diabetes Care 1999. 22(6):960-964.
- UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998. 352(9131):854-865.
- Espinosa Campos J. Metformin's effects on glucose and lipid metabolism in patients with secondary failure to sulfonylureas. Diabetes Care 1996. 19(11):1185-1189.
- Yamakido M. Incidence of non-insulin-dependent diabetes mellitus and its risk factors in Japanese-Americans living in Hawaii and Los Angeles. Diabet Med 1996. 13(9 Suppl 6):S133-142.
- Garber AJ, Duncan TG, Goodman AM, Mills DJ, Rohlf JL. Efficacy of metformin in type II diabetes: results of a double-blind, placebo-controlled, dose-response trial. Am J Med 1997. 103(6):491-497.
- Ohmura C, Tanaka Y, Mitsuhashi N, Atsumi Y, Matsuoka K, Onuma T, Kawamori R. Efficacy of low-dose metformin in Japanese patients with type 2 diabetes mellitus. Current therapeutic research 1998. 59(12):889-895.
- Johansen K. Acarbose treatment of sulfonylurea-treated non-insulin dependent diabetics. A double-blind cross-over comparison of an alpha-glucosidase inhibitor with metformin.. Diabete Metab 1984. 10(4):219-223.
- Inzucchi SE, Maggs DG, Spollett GR, Page SL, Rife FS, Walton V, Shulman GI. Efficacy and metabolic effects of metformin and troglitazone in type II diabetes mellitus. N Engl J Med 1998. 338(13):867-872.
- Moller DE. Role of AMP-activated protein kinase in mechanism of metformin action. J Clin Invest 2001. 108(8):1167-1174.
- Giugliano D, De Rosa N, Di Maro G, Marfella R, Acampora R, Buoninconti R, D'Onofrio F. Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women. Diabetes Care 1993. 16(10):1387-1390.
- Giugliano D, Quatraro A, Consoli G, Minei A, Ceriello A, De Rosa N, D'Onofrio F. Metformin for obese, insulin-treated diabetic patients: improvement in glycaemic control and reduction of metabolic risk factors. Eur J Clin Pharmacol 1993. 44(2):107-112.
- Vigneri R, Goldfine ID. Role of metformin in treatment of diabetes mellitus. Diabetes Care 1987. 10(1):118-122.
- Fedele D, Tiengo A, Nosadini R, Marchiori E, Briani G, Garotti MC, Muggeo M. Hypolipidemic effects of metformin in hyperprebetalipoproteinemia. Diabete Metab 1976. 2(3):127-133.
- Rains SG, Wilson GA, Richmond W, Elkeles RS. The effect of glibenclamide and metformin on serum lipoproteins in type 2 diabetes. Diabet Med 1988. 5(7):653-658.
- Nagi DK, Yudkin JS. Effects of metformin on insulin resistance, risk factors for cardiovascular disease, and plasminogen activator inhibitor in NIDDM subjects. A study of two ethnic groups. Diabetes Care 1993. 16(4):621-629.
- Marchesini G, Brizi M, Bianchi G, Tomassetti S, Zoli M, Melchionda N. Metformin in non-alcoholic steatohepatitis. Lancet 2001. 358(9285):893-894.
- Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, McCullough AJ, Natale S, Forlani G, Melchionda N. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes 2001. 50(8):1844-1850.
- Marchesini G, Brizi M, Morselli Labate AM, Bianchi G, Bugianesi E, McCullough AJ, Forlani G, Melchionda N. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med 1999. 107(5):450-455.
- Mertes G. Safety and efficacy of acarbose in the treatment of Type 2 diabetes: data from a 5-year surveillance study. Diabetes Res Clin Pract 2001. 52(3):193-204.
- Chiasson JL, Josse RG, Hunt JA, Palmason C, Rodger NW, Ross SA, Ryan EA, Tan MH, Wolever TM. The efficacy of acarbose in the treatment of patients with non-insulin-dependent diabetes mellitus. A multicenter controlled clinical trial. Ann Intern Med 1994. 121(12):928-935.
- Reaven GM, Lardinois CK, Greenfield MS, Schwartz HC, Vreman HJ. Effect of acarbose on carbohydrate and lipid metabolism in NIDDM patients poorly controlled by sulfonylureas. Diabetes Care 1990. 13 Suppl 3:32-36.
- Yoshino G, Furukawa S, Hirano T, Naito H, Kazumi T, Urayama T. The minimum dose of acarbose suppresses triglyceride concentration in remnant-like particles from fasted diabetic subjects. Horm Metab Res 1996. 28(7):329-330.
- Leonhardt W, Hanefeld M, Fischer S, Schulze J. Efficacy of alpha-glucosidase inhibitors on lipids in NIDDM subjects with moderate hyperlipidaemia. Eur J Clin Invest 1994. 24 Suppl 3:45-49.
- Calle Pascual A, Garcia Honduvilla J, Martin Alvarez PJ, Calle JR, Maranes JP. Influence of 16-week monotherapy with acarbose on cardiovascular risk factors in obese subjects with non-insulin-dependent diabetes mellitus: a controlled, double-blind comparison study with placebo. Diabetes Metab 1996. 22(3):201-202.
|
Respond
on this Journal Article!
Hint: Your Response should directly apply to "Low Dose" Metformin Improves Hyperglycemia Better Than Acarbose in Type 2 Diabetics.
Please check, if this context applies best to your contribution. Otherwise click HERE to change to the appropriate
subject area. The actual subject area is Metabolic Control.
|
|