Metformin for obese, insulin-treated diabetic patients: improvement in glycaemic control and reduction of metabolic risk factors

D. Giugliano, A. Quatraro, G. Consoli, A. Minei, A. Ceriello, N. De Rosa, F. D'Onofrio

Research output: Contribution to journalArticlepeer-review

Abstract

The efficacy and safety of metformin in the treatment of obese, non-insulin-dependent, diabetic subjects poorly controlled by insulin after secondary failure to respond to sulphonylureas has been investigated. Fifty insulin-treated, obese diabetics participated in this prospective, randomised double-blind six-month trial. After a four-week run-in period, during which all patients were given placebo (single-blind), patients were randomly assigned to continue to receive placebo or to active treatment with metformin. At six months, there was a relevant and significant improvement in glycaemic control in diabetics receiving the combined insulin-metformin treatment (decrease in glucose -4.1 mmol·l-1; glycosylated haemoglobin A1 decrease -1.84%). No significant changes were seen in diabetics receiving insulin and placebo. There was a significant decrease in blood lipids (trygliceride and cholesterol), an increase in HDL-cholesterol and a reduction in blood pressure in diabetics taking metformin. These postive findings were most marked in the 14 diabetics who experienced a good response to metformin (glucose profile -1), and were less marked but still significant in the remaining 13 diabetics, whose response to therapy was not so good (glucose profile >10 mmol·l-1). The fasting insulin level was significantly lower after six months of combined insulin-metformin treatment as shown by a 25% reduction in the daily dose of insulin (-21.6 U/day). Metformin was well tolerated by all diabetics. Combining metforming with insulin in obese, insulin-treated and poorly controlled diabetics may represent a safe strategy to achieve better glycaemic control with a reduction in certain metabolic risk factors associated with the increased incidence of cardiovascular disease in diabetes mellitus.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalEuropean Journal of Clinical Pharmacology
Volume44
Issue number2
DOIs
Publication statusPublished - Mar 1993

Keywords

  • adverse effects
  • blood pressure
  • combined therapy
  • Diabetes mellitus
  • glucose homoeostasis
  • Metformin
  • noninsulin-dependent
  • plasma lipids
  • secondary failure to sulphonylureas

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)

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