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Metformin Has Positive Effect on Glucose Kinetics When Combined with Exercise

Jan 16, 2015

But the effects are modest and type 2 patients on metformin can do moderate exercise without undue fear of hypoglycemia…

Before, during, and after a 45-min bout of exercise at 60% VO2max, glucose kinetics were determined by isotope tracer technique in patients with type 2 diabetes mellitus with metformin treatment (DM2+Met) or without metformin treatment (DM2) and in healthy control subjects (CON) matched for BMI and age. Glucoregulatory hormones and metabolites were measured throughout the study.

Plasma glucose concentration was unchanged during exercise in CON but decreased in DM2. No significant change was found in DM2+Met. Hormones and metabolites showed no differences among the groups except for elevated exercise-induced concentrations of lactate in DM2 (area under the curve [AUC] 31 ± 1% vs. CON) and glucagon in DM2 (AUC 5 ± 1% vs. DM2+Met). Free fatty acid levels were lower in DM2+Met than in DM2 (AUC −14 ± 1%). Absolute values of the baseline glucose rate of appearance (Ra) were elevated in DM2 and DM2+Met, but the increase in glucose Ra relative to baseline was blunted in DM2 (19 ± 1%) and DM2+Met (18 ± 4%) compared with CON (46 ± 4%). Glucose rate of disappearance relative to baseline increased more in CON (31 ± 3%) than in DM2 (6 ± 1%) and DM2+Met (21 ± 2%), showing a small increase caused by metformin. Glucose metabolic clearance rate relative to baseline was similar during exercise in DM2 (33 ± 1%) and CON (35 ± 3%) but was improved in DM2+Met (37 ± 3%) compared with DM2.

The researchers concluded that metformin has a positive effect on glucose homeostasis during exercise.

Practice Pearls:

  • Researchers studied glucose kinetics before, during, and after exercise via isotope tracers. Patients were in clusters of diabetics on and off metformin and controls matched for BMI and age.
  • Metformin increased the rate of glucose metabolic clearance during exercise and lowered free fatty acid levels.

The Effect of Metformin on Glucose Homeostasis During Moderate Exercise, Diabetes Care 2014 Dec 02;[EPub Ahead of Print], M Hansen.