Abstract


Bookmark and Share

Long-term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus

Kooy A, de Jager J, Lehert P, Bets D, Wulffelé MG, Donker AJ, Stehouwer CD.
Arch Intern Med 2009;169:616-25


BACKGROUND: We investigated whether metformin hydrochloride has sustained beneficial metabolic and (cardio) vascular effects in patients with type 2 diabetes mellitus (DM2). METHODS: We studied 390 patients treated with insulin in the outpatient clinics of 3 hospitals in a randomized, placebo-controlled trial with a follow-up period of 4.3 years. Either metformin hydrochloride, 850 mg, or placebo (1-3 times daily) was added to insulin therapy. The primary end point was an aggregate of microvascular and macrovascular morbidity and mortality. The secondary end points were microvascular and macrovascular morbidity and mortality, as separate aggregate scores. In addition, effects on hemoglobin A(1c) (HbA(1c)), insulin requirement, lipid levels, blood pressure, body weight, and body mass index were analyzed. RESULTS: Metformin treatment prevented weight gain (mean weight gain, -3.07 kg [range, -3.85 to -2.28 kg]; P < .001), improved glycemic control (mean reduction in HbA(1c) level, 0.4% percentage point [95% CI, 0.55-0.25]; P < .001) (where CI indicates confidence interval), despite the aim of similar glycemic control in both groups, and reduced insulin requirements (mean reduction, 19.63 IU/d [95% CI, 24.91-14.36 IU/d]; P < .001). Metformin was not associated with an improvement in the primary end point. It was, however, associated with an improvement in the secondary, macrovascular end point (hazard ratio, 0.61 (95% CI, 0.40-0.94; P = .02), which was partly explained by the difference in weight. The number needed to treat to prevent 1 macrovascular end point was 16.1 (95% CI, 9.2-66.6). CONCLUSIONS: Metformin, added to insulin in patients with DM2, improved body weight, glycemic control, and insulin requirements but did not improve the primary end point. Metformin did, however, reduce the risk of macrovascular disease after a follow-up period of 4.3 years. These sustained beneficial effects support the policy to continue metformin treatment after the introduction of insulin in any patient with DM2, unless contraindicated. Trial Registration ClinicalTrials.gov Identifier: NCT00375388.

 

Arch Intern Med 2009;169:616-25

 


Area Soci

Eventi

31° Congresso Nazionale


31° Congresso Nazionale

Palermo, 19-21 novembre 2017
Programma completo

[continua a leggere]

Congresso SISA Sezione Piemonte, Liguria e Valle d’Aosta

Genova, 2 Dicembre 2017

[continua a leggere]

Congresso Regionale SISA Sezione Campania

Napoli, 9 Novembre 2017

[continua a leggere]

Congresso Regionale SISA Sezione Lombardia

Milano, 19-21 Ottobre 2017
Assegnati i premi

[continua a leggere]

Giornale Italiano Arteriosclerosi

Rivista in lingua italiana
riservata ai Soci S.I.S.A.
Ultimo numero:
Anno 8 • N.4/2017

[continua a leggere]

Rivista NMCD

Nutrition, Metabolism and Cardiovascular Diseases

Istruzioni per l'accesso online

IF 2015: 3.390


Newsletter

Per essere informati sulle novità di S.I.S.A. iscrivetevi alla nostra newsletter inserendo
il vostro indirizzo di posta elettronica

Progetto LIPIGEN

LIPIGEN
Nuovo sito dedicato al Progetto LIPIGEN

 

Progetto LIPIGEN - Vecchio portale
E' necessario essere loggati come utente
Lipigen per poter accedere alla pagina

PROject Statin Intolerance SISA

 

PROSISA – PROject Statin Intolerance SISA
E' necessario essere loggati come utente
PROSISA per poter accedere alla pagina

GILA - Lipoprotein Aferesi

 

Gruppo Interdisciplinare Lipoprotein Aferesi
(Accesso Gruppo GILA-Lipoprotein Aferesi)

E' necessario essere loggati come utente del Gruppo GILA per poter accedere

 

Gruppo Interdisciplinare Lipoprotein Aferesi
(Documentazione ad accesso libero)

Pagina informativa per medici e pazienti