The latest study shows that long-term use of metformin therapy is safe to prevent or delay the onset of type 2 diabetes, and the results were published in the April issue of Diabetes Care.
The new data from the Open Labelled Trial-DPPOS (Diabetes Prevention Plan Outcomes) Study show that metformin is able to “mildly and lastingly reduce weight by 2%†within 10 years of drug use, and it has better safety and tolerance Receptive.
This result supports the previous conclusion of a three-year DPP double-blind study that metformin (850 mg, bid) contributes to stable weight loss. Whether it is metformin or placebo, weight loss is an important predictor of diabetes prevention.
The Diabetes Prevention Program research team pointed out that the weight loss caused by metformin may vary with caloric restriction, limiting the effect of calories on adipose tissue over lean body mass. Metformin may also have similar effects to exercise.
As previously reported by Medscape Medical News, metformin treatment is a more cost-effective alternative to lifestyle interventions in the prevention of diabetes.
Vivian Fonseca, chair of the Medical Sciences Division of the American Diabetes Association, said: "We now know how to prevent type 2 diabetes. There are data showing that metformin is not only safe and more cost-effective in preventing diabetes. We should take more steps to reduce the serious threat of diabetes, humans The prevalence of healthy diseases in our country. I will encourage every American to use simple tools to assess their diabetes risk, and then take simple measures to prevent the occurrence of the disease when there is a risk."
More than 10 years of experience with metformin: Mild and lasting weight loss The DPP study randomized overweight and obese subjects with impaired glucose tolerance and assigned them to lifestyle interventions, metformin, and placebo. The results published in 2002 showed that metformin treatment reduced the incidence of diabetes by 31% during a mean follow-up of 2.8 years. During the study, the metformin-treated group lost weight compared with placebo (2.06% ± 5.65% vs 0.02% ± 5.52%, P <0.001), waist circumference decreased (2.13 cm ± 7.06 cm vs. 0.79 cm ± 6.54 cm, P < 0.001). In a 10-year follow-up non-double-blind randomized study, weight loss was still significant in the metformin group compared with the placebo group (2.0% vs. 0.2%, P < 0.001) and correlated with the degree of adherence to treatment. Subjects with higher adherence to metformin treatment had a 3.5% weight loss (3.1 kg, or 6.8 pounds), whereas those with lower compliance had only a reduction in body weight at the beginning, and were subsequently treated with placebo until the 5th year of treatment. The weight of the group changed quite a bit (weight began to increase).
The researchers emphasized that waist circumference will increase after 2 years of treatment, but the waist circumference of those with higher compliance will only increase after 5 years. Because the body weight did not increase, the researchers concluded that it was central obesity through the distribution of body fat. The researchers wrote: "Metformin-induced weight loss is mainly achieved by reducing the amount of fat, which has little effect on lean body mass." Compared to the weight-reducing weight loss, the pattern is different. The former can reduce lean body mass and adipose tissue. The investigators also emphasized that metformin can also affect energy metabolism, for example, it can affect the phosphorylation of AMP-activated protein kinase, an important regulator of mitochondrial biogenesis, hepatic and muscle fatty acid oxidation, glucose transport, insulin secretion, and adipogenesis. .
William T, Pennington Center for Biomedical Research. Dr. Cefalu said in an article's editorial: "Overall, clinical data suggest that long-lasting weight loss, combined with an impact on cellular energy metabolism, supports metformin as a viable strategy that can be widely used to prevent diabetes.
Long-term use of metformin is generally safe and well-tolerated during the first 4 years of the DPP study. Compared with the placebo group, metformin subjects experienced more frequent drug-related gastrointestinal adverse reactions (9.5% vs 1.15). P<0.001). However, these adverse reactions decreased over time, and the incidence of adverse reactions between the two groups was comparable between the 6th and 9th year (P > 0.10).
Severe hypoglycemia and anemia are rare, and the rates of incidence are similar between the metformin and placebo groups (7 vs. 8 and 50 vs. 38, respectively). Serious adverse events were rare. There were only 3 cases of severe anaemia (2 cases in the metformin group and 1 case in the placebo group). No lactic acidosis occurred.
In the DPP study, subjects in the metformin-treated group experienced a slight decrease in their mean hemoglobin and hematocrit during the first year, but remained stable thereafter (13.6 mg/dl vs. 13.8 mg/dl and 40.6% vs. 41.1%. P was <0.001). Although the proportion of low-hemoglobin patients was comparable between the two groups (11.2% vs 7.6%, P=0.17), the proportion of patients with metformin-treated subjects with lower hematocrit was higher (12.6% vs. 8.4%; P =0.035). The investigators emphasized that 12% of subjects in the DPP study chose not to continue their follow-up studies, probably because of concerns that adverse events may affect safety and tolerability.
The new data from the Open Labelled Trial-DPPOS (Diabetes Prevention Plan Outcomes) Study show that metformin is able to “mildly and lastingly reduce weight by 2%†within 10 years of drug use, and it has better safety and tolerance Receptive.
This result supports the previous conclusion of a three-year DPP double-blind study that metformin (850 mg, bid) contributes to stable weight loss. Whether it is metformin or placebo, weight loss is an important predictor of diabetes prevention.
The Diabetes Prevention Program research team pointed out that the weight loss caused by metformin may vary with caloric restriction, limiting the effect of calories on adipose tissue over lean body mass. Metformin may also have similar effects to exercise.
As previously reported by Medscape Medical News, metformin treatment is a more cost-effective alternative to lifestyle interventions in the prevention of diabetes.
Vivian Fonseca, chair of the Medical Sciences Division of the American Diabetes Association, said: "We now know how to prevent type 2 diabetes. There are data showing that metformin is not only safe and more cost-effective in preventing diabetes. We should take more steps to reduce the serious threat of diabetes, humans The prevalence of healthy diseases in our country. I will encourage every American to use simple tools to assess their diabetes risk, and then take simple measures to prevent the occurrence of the disease when there is a risk."
More than 10 years of experience with metformin: Mild and lasting weight loss The DPP study randomized overweight and obese subjects with impaired glucose tolerance and assigned them to lifestyle interventions, metformin, and placebo. The results published in 2002 showed that metformin treatment reduced the incidence of diabetes by 31% during a mean follow-up of 2.8 years. During the study, the metformin-treated group lost weight compared with placebo (2.06% ± 5.65% vs 0.02% ± 5.52%, P <0.001), waist circumference decreased (2.13 cm ± 7.06 cm vs. 0.79 cm ± 6.54 cm, P < 0.001). In a 10-year follow-up non-double-blind randomized study, weight loss was still significant in the metformin group compared with the placebo group (2.0% vs. 0.2%, P < 0.001) and correlated with the degree of adherence to treatment. Subjects with higher adherence to metformin treatment had a 3.5% weight loss (3.1 kg, or 6.8 pounds), whereas those with lower compliance had only a reduction in body weight at the beginning, and were subsequently treated with placebo until the 5th year of treatment. The weight of the group changed quite a bit (weight began to increase).
The researchers emphasized that waist circumference will increase after 2 years of treatment, but the waist circumference of those with higher compliance will only increase after 5 years. Because the body weight did not increase, the researchers concluded that it was central obesity through the distribution of body fat. The researchers wrote: "Metformin-induced weight loss is mainly achieved by reducing the amount of fat, which has little effect on lean body mass." Compared to the weight-reducing weight loss, the pattern is different. The former can reduce lean body mass and adipose tissue. The investigators also emphasized that metformin can also affect energy metabolism, for example, it can affect the phosphorylation of AMP-activated protein kinase, an important regulator of mitochondrial biogenesis, hepatic and muscle fatty acid oxidation, glucose transport, insulin secretion, and adipogenesis. .
William T, Pennington Center for Biomedical Research. Dr. Cefalu said in an article's editorial: "Overall, clinical data suggest that long-lasting weight loss, combined with an impact on cellular energy metabolism, supports metformin as a viable strategy that can be widely used to prevent diabetes.
Long-term use of metformin is generally safe and well-tolerated during the first 4 years of the DPP study. Compared with the placebo group, metformin subjects experienced more frequent drug-related gastrointestinal adverse reactions (9.5% vs 1.15). P<0.001). However, these adverse reactions decreased over time, and the incidence of adverse reactions between the two groups was comparable between the 6th and 9th year (P > 0.10).
Severe hypoglycemia and anemia are rare, and the rates of incidence are similar between the metformin and placebo groups (7 vs. 8 and 50 vs. 38, respectively). Serious adverse events were rare. There were only 3 cases of severe anaemia (2 cases in the metformin group and 1 case in the placebo group). No lactic acidosis occurred.
In the DPP study, subjects in the metformin-treated group experienced a slight decrease in their mean hemoglobin and hematocrit during the first year, but remained stable thereafter (13.6 mg/dl vs. 13.8 mg/dl and 40.6% vs. 41.1%. P was <0.001). Although the proportion of low-hemoglobin patients was comparable between the two groups (11.2% vs 7.6%, P=0.17), the proportion of patients with metformin-treated subjects with lower hematocrit was higher (12.6% vs. 8.4%; P =0.035). The investigators emphasized that 12% of subjects in the DPP study chose not to continue their follow-up studies, probably because of concerns that adverse events may affect safety and tolerability.
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