Created for treatment of type 2 diabetes, metformin is manufactured by Bristol-Myers-Squibb Company and was approved for use in the U.S. and U.K. in December of 1994. Metformin is only an effective diabetes treatment in the presence of insulin as its main function is to increase the effectiveness of the body’s own insulin, reduce the amount of glucose produced by the liver, and the absorption of glucose by the small intestines.
Prevention of Diabetes: Metformin, Diet, and Exercise
In a study published in 2009 diet, exercise, and metformin were shown to delay the onset of diabetes by up to 10 years. The Diabetes Prevention Program Research Group led by Dr. William C. Knowler, studied the effects of diet, exercise, and metformin on 3,800 over weight individuals with high risk of developing type 2 diabetes over 15 years. Subjects were broken into three groups. One received intensive diet and exercise training and counseling, another diet and exercise information and 850 mg of metformin twice a day, and the third received the same diet and exercise information with a placebo. Average follow-up was every 2.8 years, finding at the end of the study the diet and exercise group reduced their risk of diabetes by 58% while the group on metformin showed a 31% reduction in later diagnosis versus the group on the placebo pill. The incidence of diabetes diagnosis was 11 for the placebo group, 7.8 for those on metformin, and 4.8 cases per 100 persons in the exercise group. Of the individuals in the diet and exercise group, lifestyle changes were most effective in people over 60 while metformin was most effective in people between the ages of 25-44 and in people with a body mass index of 35 or greater (60 pounds overweight).
Diabetes Treatment: Metformin Combination Therapy
An efficacy test conducted in 1995 by the Diabetes Division of the University of Texas Health Science Center tested metformin as a monotherapy and combination therapy with sulpohonylureas. The study found that glycemic control and lipids were both improved by metformin alone and in joint therapy. Another test that found a 20% reduction in fasting glucose in metformin patients. The guidelines set forward by the American Diabetes Association (ADA) and the American Association of Endocrinologists and American College of Endocrinology (AACE) are the selection of medicines with complimentary mechanisms that target the underlying pathophysiology while taking into account the individual clinical factors of each patient. Both agencies recommend metformin as a “firstline” oral therapy. The agencies diverge in their support of secondary medications with the ADA recommending insulin and sulphonylureas and the AACE recommending GLP-1 receptor agonists and DDP-4 inhibitors.
Related articles: Diabetes Capsule |
