Effect of metformin treatment on multiple cardiovascular disease risk factors in patients with type 2 diabetes mellitus☆
Section snippets
Materials and methods
The study participants were recruited from the San Francisco Bay area by advertisements in local newspapers indicating our interest in studying risk factors for CVD in hyperglycemic patients with type 2 diabetes mellitus. The Stanford Human Subjects Committee approved the experimental protocol, and each volunteer gave written informed consent. The study was performed at the General Clinical Research Center of Stanford University Medical Center. Thirty-one volunteers with type 2 diabetes, 22 men
Results
Neither blood pressure nor weight changed significantly after metformin treatment in either group. The effect of metformin on glycemic control in the 2 groups is shown in Table 2. It is apparent that both fasting plasma glucose and HbA1c concentrations decreased significantly (P < .01) in both groups. If anything, the decrements in both variables were somewhat greater in those in whom the metformin was added to the SU compound, and in this group the improvement in fasting plasma glucose and HbA
Discussion
Perhaps the most appropriate way to begin discussing our results is to make a clear statement that our findings do not offer an answer to the question whether or not the long-term benefits of metformin treatment vary as a function of its use as monotherapy versus its impact when added to a SU compound in patients with type 2 diabetes in less than optimal glycemic control. There is no doubt that its addition will effectively lower plasma glucose concentrations in SU-treated patients that remain
References (29)
- et al.
Identification of multiple subclasses of plasma low density lipoproteins in normal humans
J Lipid Res
(1982) - et al.
Plasma concentration of soluble intercellular adhesion molecule 1 and risks of future myocardial infarction in apparently healthy men
Lancet
(1998) - et al.
Serum concentrations of soluble adhesion molecules are related to degree of hyperglycemia and insulin resistance in patients with type 2 diabetes mellitus
Diabetes Res Clin Pract
(2002) - et al.
Plasma free fatty acid levels and the risk of ischemic heart disease in menProspective results from the Quebec Cardiovascular Study
Atherosclerosis
(2002) - et al.
Improved endothelial function with metformin in type 2 diabetes mellitus
J Am Coll Cardiol
(2001) - et al.
Metformin treatment lowers asymmetric dimethylarginine concentrations in patients with type 2 diabetes
Metabolism
(2002) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34)
Lancet
(1998)- et al.
Increased mortality in type II diabetic patients using sulphonylurea and metformin in combinationA population-based observational study
Diabetologia
(2000) - et al.
Oral anti-diabetic treatment in patients with coronary artery diseaseTime-related increased mortality on combined glyburide/metformin therapy over a 7.7 year follow-up
Clin Cardiol
(2001) - et al.
Combined metformin-sulfonylurea treatment of patients with noninsulin-dependent diabetes in fair to poor glycemic control
J Clin Endocrinol Metab
(1992)
Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations. A double-blind controlled study
Diabetes Care
Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group
N Engl J Med
Results of a placebo-controlled study of the metabolic effects of the addition of metformin to sulfonylurea-treated patients. Evidence for a central role of adipose tissue
Diabetes Care
Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35)Prospective observational study
BMJ
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Supported by Research Grants from the National Institutes of Health (RR-00070 and DK 30732).