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Metformin Has Major Benefits for African Americans

African Americans with type 2 diabetes respond better to metformin’s glucose lowering effects….

Metformin is the number one most prescribed drug used to treat T2D. Not many studies have been done to measure its effectiveness in individual ethnicity. This study was conducted to assess whether metformin’s effect on controlling blood glucose differs between African Americans and European Americans.

Electronic health records were used to identify patients who were diagnosed with diabetes, had two or more fills of metformin between 1997-2013, and had had at least two HbA1c measurements. Of the 19,672 diabetic patients who were identified, 7,429 were African Americans and 8,783 were European Americans. Analyses of the results were based on the ethnicity and their HbA1c levels while taking metformin. The patients in the African American group compared to the European Americans were typically younger (55.1 vs. 59.5 years), more were women (58.6% vs 47.8%), and they had higher baseline HbA1c levels (7.81% vs 7.38%) respectively.

When adjusted for age, sex, ethnicity, BMI, and baseline HbA1c levels, the use of metformin at the maximum dose of 2550mg/day was associated with 0.62% point reduction in HbA1c compared with no metformin use. The study also showed a significant difference between African Americans and European Americans (P<0.001). Metformin use was associated with a 0.9% HbA1c reduction from baseline among African Americans and only 0.42% reduction in European Americans.

Practice Pearls:
  • Metformin use was associated with a 0.9% HbA1c reduction from baseline among African Americans and only 0.42% reduction in European Americans.
  • African American patients showed a better glucose lowering response to metformin than European Americans in the study and an overall 0.62% point reduction in HbA1c when compared with no metformin use.
  • Genetic influences can play a role in differentiating HbA1c levels, but more studies are required.

Williams LK, Padhukasahasram B, Ahmedani BK, et al. Differing Effects of Metformin on Glycemic Control by Race-Ethnicity.The Journal of Clinical Endocrinology & Metabolism. 2014 June 12.