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Quantifying the Effect of Metformin 1000 mg/day in Japanese Patients with Type 2 Diabetes

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DOI: 10.4236/ijcm.2014.515120    2,864 Downloads   3,551 Views  

ABSTRACT

Objective: To examine the effect of high-dose metformin on glucose metabolism in Japanese patients with type 2 diabetes. Method: A total of 144 patients with type 2 diabetes who could be followed up for 6 months after their dose of metformin was increased to 1000 mg/day (from 750 mg/day or less) were examined. The dose of metformin was increased from 750 mg/day in 70 subjects (250-mg dose increase) and from 500 mg/day in 74 subjects (500-mg dose increase). Results: After the dose increased to 1000 mg/day, HbA1c was significantly decreased by 0.65% ± 0.7%, 0.42% ± 0.5%, and 0.87% ± 0.7% in all subjects, the 250-mg dose increase group, and the 500-mg dose increase group, respectively. No significant change was observed in weight. Analysis by BMI (<25 kg/m2 and ≥25 kg/m2) revealed a comparable significant decrease in HbA1c in all subjects, the 250-mg dose increase group, and the 500-mg dose increase group. Analysis by duration of diabetes showed a significant decrease in HbA1c regardless of the duration. Conclusion: Increasing the metformin dose to 1000 mg/day showed a significant antihyperglycemic effect over 6 months in Japanese patients with type 2 diabetes. Blood glucose improved regardless of the duration of diabetes or the presence or absence of obesity. Overall tolerability was favorable.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Suzuki, K. , Yoshioka, T. and Wakui, Y. (2014) Quantifying the Effect of Metformin 1000 mg/day in Japanese Patients with Type 2 Diabetes. International Journal of Clinical Medicine, 5, 894-901. doi: 10.4236/ijcm.2014.515120.

References

[1] Defronzo, R.A. and Goodman, A.M. (1995) Efficacy of Metformin in Patients with Non-Insulin-Dependent Diabetes Mellitus. The Multicenter Metformin Study Group. The New England Journal of Medicine, 333, 541-549.
http://dx.doi.org/10.1056/NEJM199508313330902
[2] UK prospective Diabetes Study (UKPDS) Group (1998) Effect of Intensive Blood-Glucose Control with Metformin on Complications in Overweight Patients with Type 2 Diabetes (UKPDS 34). Lancet, 352, 854-865.
http://dx.doi.org/10.1016/S0140-6736(98)07037-8
[3] Holman, R.R., Paul, S.K., Bethel, M.A., et al. (2008) 10-Years Follow-Up of Intensive Glucose Control in Type 2 Diabetes. The New England Journal of Medicine, 359, 1577-1589.
http://dx.doi.org/10.1056/NEJMoa0806470
[4] International Diabetes Federation (2005) Glucose Control: Oral Therapy. Global Guideline for Type 2 Diabetes. 35-38,
[5] Nathan, D.M., Buse, J.B., Davidson, M.B., et al. (2008) Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy: Update Regarding Thiazolidinediones: A Consensus Statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 31, 173-175.
http://dx.doi.org/10.2337/dc08-9016
[6] Garber, A.J., Duncan, T.G., Goodman, A.M., Mills, D.J. and Rohlf, J.L. (1997) Efficacy of Metformin in type II Diabetes: Results of a Bouble-Blind, Placebo-Controlled, Dose-Response Trial. The American Journal of Medicine, 103, 491-497.
http://dx.doi.org/10.1016/S0002-9343(97)00254-4
[7] Kaku, K., Tajima, N. and Kawamori, Y. (2006) Melbin Observational Research (MORE) Study of Metformin Therapy in Patients with Type 2 Diabetes Mellitus. Tonyobyo (Diabetes), 49, 325-331. In Japanese.
[8] Sumintani, S., Morita, S., Utsu, Y., Mukai, K., Miki, S., Sato, B., Nakamura, H. and Kasayama, S. (2012) Effectiveness of Metformin and Lifestyle Interventions as an Initial Treatment in Japanese Patients with Observational Study. The Journal of Medical Investigation, 59, 166-173.
http://dx.doi.org/10.2152/jmi.59.166
[9] Edited by the Japan Diabetes Society (2014-2015) Treatment Guide for Diabetes. 24-25.
[10] Okuno, Y., Sakaguchi, K., Komada, H., Hashimoto, N., Hirota, Y., Nakamura, T., Ogawa, W. and Seino, S. (2013) Correlation of Serum CPR to Plasma Glucose Ratio with Various Indices of Insulin Secretion and Diseases Duration in Type 2 Diabetes. Kobe Journal of Medical Sciences, 59, E44-E53.
[11] Baily, C.J., et al. (1994) Insulin Requirement for the Antihyperglycaemic Effect of Metformin. British Journal of Pharmacology, 111, 793-796.
http://dx.doi.org/10.1111/j.1476-5381.1994.tb14807.x
[12] Zhou, G., Myers, R., Li, Y., Chen, Y., Shen, X., Fenyk-Melody, J., Wu, M., Ventre, J., Doebber, T., Fujii, N., Musi, N., Hirshman, M.F., Goodyear, L.J. and Moller, D.E. (2001) Role of AMP-Activated Protein Kinase in Mechanism of Metformin Action. Journal of Clinical Investigation, 108, 1167-1174.
http://dx.doi.org/10.1172/JCI13505
[13] Miller, R.A., Chu, Q., Xie, J., Foretz, M., Viollet, B. and Birnbaum, M.J. (2013) Biguanides Suppress Hepatic Glucagon Signalling by Decreasing Production of Cyclic AMP. Nature, 494, 256-260.
http://dx.doi.org/10.1038/nature11808
[14] Bailey, C.J. and Howlett, H.C.S. (2008) Tolerability of Metformin. In: Bailey, C.J., Campbell, I.W., Chan, J.C.N., et al, Metformin: The Gold Standard, John Wiley and Sons Ltd., Chichester, 173-178.

  
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