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Diabetes Medications and Body Composition

Metformin found to decrease fat…. 

Weight gain is a common side effect of many oral diabetes medications. Despite many research studies evaluating the effect of diabetes medications on change in body weight, there remains very little data on the effect of these medications on the composition of this change in body weight.

Because body weight composition may be a better indicator of cardiovascular risks associated with type 2 diabetes, researchers in this study set out to determine the effects of gliclazide, metformin, and acarbose monotherapy on body composition in patients with type 2 diabetes. Additional outcome measures included fat distribution, and cardiometabolic risk factors such as body weight, fat distribution, blood pressure, lipid profile, and adipocytokines.

A total of 86 patients with newly diagnosed type 2 diabetes and HbA1c within 7-10% underwent a month of diet treatment and were then randomized to receive gliclazide, metformin, or acarbose monotherapy for a duration of 6 months. Drug dose was determined based on individual blood glucose level. Patients were treated to a target HbA1c of <7%.

Both HbA1c and blood glucose were found to improve significantly after 6 months of therapy. Metformin monotherapy was found to have a significant decrease in both percent body fat (P=0.029) and fat mass (P=0.038). Total cholesterol and triglycerides also improved significantly on metformin therapy. Researchers saw no significant differences in abdominal fat, waist circumference, or blood pressure changes associated with any of the 6-month medication regimens.

Practice Pearls: 
  • Metformin monotherapy appears to have a favorable effect on both total cholesterol and triglycerides in patients with newly diagnosed type 2 diabetes.
  • Metformin monotherapy may significantly decrease percent body fat and fat mass.
  • Metformin monotherapy appears to improve cardiovascular risk factors in patients with newly diagnosed type 2 diabetes.

[Wang, H. et al. The Effects of Gliclazide, Metformin, and Acarbose on Body Composition in Patients with Newly Diagnosed Type 2 Diabetes Mellitus. Current Therapeutic Research. 2013:88-92]