| Autor: |
Preiss, David, Dawed, Adem, Welsh, Paul, Heggie, Alison, Jones, Angus G., Dekker, Jacqueline, Koivula, Robert, Hansen, Tue H., Stewart, Caitlin, Holman, Rury R., Franks, Paul W., Walker, Mark, Pearson, Ewan R., Sattar, Naveed |
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| Zdroj: |
Diabetes, Obesity & Metabolism; Mar2017, Vol. 19 Issue 3, p356-363, 8p |
| Abstrakt: |
Aims To investigate, in the Carotid Atherosclerosis: Metformin for Insulin Resistance ( CAMERA) trial ( NCT00723307), whether the influence of metformin on the glucagon-like peptide ( GLP)-1 axis in individuals with and without type 2 diabetes ( T2DM) is sustained and related to changes in glycaemia or weight, and to investigate basal and post-meal GLP-1 levels in patients with T2DM in the cross-sectional Diabetes Research on Patient Stratification ( DIRECT) study. Materials and methods CAMERA was a double-blind randomized placebo-controlled trial of metformin in 173 participants without diabetes. Using 6-monthly fasted total GLP-1 levels over 18 months, we evaluated metformin's effect on total GLP-1 with repeated-measures analysis and analysis of covariance. In the DIRECT study, we examined active and total fasting and 60-minute post-meal GLP-1 levels in 775 people recently diagnosed with T2DM treated with metformin or diet, using Student's t-tests and linear regression. Results In CAMERA, metformin increased total GLP-1 at 6 (+20.7%, 95% confidence interval [ CI] 4.7-39.0), 12 (+26.7%, 95% CI 10.3-45.6) and 18 months (+18.7%, 95% CI 3.8-35.7), an overall increase of 23.4% (95% CI 11.2-36.9; P < .0001) vs placebo. Adjustment for changes in glycaemia and adiposity, individually or combined, did not attenuate this effect. In the DIRECT study, metformin was associated with higher fasting active (39.1%, 95% CI 21.3-56.4) and total GLP-1 (14.1%, 95% CI 1.2-25.9) but not post-meal incremental GLP-1. These changes were independent of potential confounders including age, sex, adiposity and glycated haemoglobin. Conclusions In people without diabetes, metformin increases total GLP-1 in a sustained manner and independently of changes in weight or glycaemia. Metformin-treated patients with T2DM also have higher fasted GLP-1 levels, independently of weight and glycaemia. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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