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Men and Women May Respond Differently to Popular Diabetes Medications

New information on gender specific responses may help with more patient-specific prescribing…. 

In this recent study, researchers studied the response to diabetes medications in both men and women with type 2 diabetes, specifically focusing on the impact on cardiovascular metabolism and lipid levels. By determining if men and women respond differently to diabetes drugs, clinicians might be able to eventually tailor diabetes therapy more accurately to individual patients.

To identify any differences, 78 type 2 diabetes patients (43 women, 35 men) were randomized into 3 groups where they would receive common combinations of diabetes medications. The three treatment groups consisted of Metformin, Metformin + Rosiglitazone, or Metformin + Lovaza. The participants’ response to these treatments were identified by using positron emission tomography, echocardiography, and whole body tracer studies after 3 months of treatment with one of the three categories of drugs.

In the Metformin group, the men showed reduced fatty acid metabolism and reduced cardiac glucose usage as compared to the women, thus leading to increased fatty acids in their bloodstream. The women in the Metformin + Rosiglitazone group showed increased cardiac fatty acid metabolism, resulting in lower plasma fatty acid levels. The participants in the Metformin + Lovaza group had no change in their fatty acid levels, although this group was found to have an improvement in diastolic dysfunction which was much more prominent for the male patients.

Practice Pearls:
  • Men and women may respond differently to diabetes medications when comparing cardiac metabolism and fatty acid levels.
  • Men taking metformin had increased plasma fatty acids and decreased cardiac glucose utilization as compared to women taking the same medication.
  • All participants in the Metformin + Lovaza group showed improved diastolic functioning but the benefit in men was more prominent than women.

American Journal of Physiology, December 2013