The effects of metformin on fasting blood glucose, blood pressure, serum lipids, lipoproteins and body weight in type 2 diabetes mellitus | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2000]

Author(s):

1. Muhammad Azhar Mughal: Department of Pharmacology and Therapeutics, Ziauddin Medical University, Clifton, Karachi, Pakistan

2. Saeed Ahmed Mahar: Department of Medicine, Civil Hospital, Karachi, Pakistan.

3. Israr Ahmed Akhund: Department of Physiology, Liaquat Medical College, Jamshoro.Pakistan

4. Wall Muhammad Maheri: Department of Physiology, Liaquat Medical College, Jamshoro, Pakistan

5. Muhammad Jan: Department of Pharmacology and Therapeutics, Ayub Medical College, Abbottabad. Pakistan.

Abstract:

This study was undertaken to assess the effect of metformin as a second-line oral antihyperglycemic agent in a defined population. A total of 21 (12 men and 9 women) type 2 diabetics participated throughout the trial. Their ages ranged from 35-70 years, (53.3 ± 9.3 years). Body mass index (BMI) was 26.8 ± 3.5 kg/m2 and a median time since diagnosis of diabetes was 4.5 ± 2.3 years [range 1-10 years]. Patients, in whom adequate glycemic control could not be maintained with diet alone or maximum doses of sulfonylurea (SU) therapy, had suboptimal glycemic control on two occasions with significant hyperglycemic symptoms were transferred to metformin monotherapy along with diet control and were followed-up weekly for 12-weeks. Suboptimal glycemic control was considered as glucose concentration of 6-15 mmol/L or (108-270 mg/dL). Metformin treatment was initiated with a single 500 mg tablet b.i.d, and the dosage was gradually increased to two or three tablets per day depending on the patient’s metabolic changes. Individuals were studied for fasting blood glucose, blood pressure, lipid profiles and body weight before and after receiving 12 weeks of metformin. Fasting blood glucose of the total patient population decreased (227.2 ± 37.5 vs. 168.6 ± 20.5 mg/dl, P < 0.001), and also the serum total cholesterol (200.3 ± 18.7 vs. 181.4 ± 19.4 mg/dl, P < 0.01). Serum total triglycerides (159.9 ± 31.9 vs. 174.2 ± 26.6 mg/dl, P < 0.01), lowdensity lipoprotein cholesterol (123.5 ±16.9 vs. 105.5 ± 19.1 mg/dl, P < 0.01), and very-low density lipoprotein cholesterol (39.2 ± 6.4 vs. 34.8 ± 5.3 mg/dl, P < 0.01) were significantly lower following metformin treatment, while high-density lipoprotein cholesterol concentration (37.7 ± 5.1 vs. 39.5 ± 4.9 mg/dl, P less than 0.01) was significantly increased. Blood pressure decreased significantly (systolic from 132 ± 9.2 to130 ±10.7 mmHg, . P< 0.05, and diastolic from 91 ± 2.2 to 82 ± 4.4 mmHg, P< 0.001). Mean body weight decreased in the subjects allocated to metformin (76.1 ± 7.3 vs. 75.8 ± 7.5 kg), but the change was found statistically insignificant. The body mass index does not change significantly within the relatively short follow-up period. No serious adverse events were observed. Metformin monotherapy resulted in better glycemic control in patients with type 2 diabetes whose glycemia had not been well controlled on diet alone or with sulfonylurea therapy. However, it is difficult to obtain optimal glycemic control. Metformin was better accepted by patients and provides a modest advantage in terms of blood pressure, body weight and serum lipids and lipoproteins.

Page(s): 405-408

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 10, Issue: 11, Year: 2000

Keywords:

Diabetes Mellitus , Metformin Hyperglycemia Blood glucose Body weight

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