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Metformin Treatment Provides Better Lipid Control

Better overall lipid effects were seen in type 2 diabetes patients with coronary artery disease treated with metformin than those being treated with glipizide….

Results were analyzed in the SPREAD-DIMCAD study and 44 patients were evaluated, 23 on metformin and 21 on glipizide. 

Using the SMART (scaled-to-maximum, aligned, and reduced trajectories) model strategy, researchers discovered metformin had a significant impact on lipid metabolism compared to glipizide treatment in type 2 diabetes patients with coronary artery disease.

The researchers found an association of three lipid metabolites, phosphatidylcholine, sphingomyelin (d18:0-24:1), and sphingomyelin (d18:1-20:1) with long term cardiovascular complications. 

Dr. Zhang from Shanghai Jiao-Tong University School of Medicine, China, indicated metformin treatment would be preferred in type 2 diabetes patients who are at high risk of CV events over glipizide. She also believed detailed lipid profiles should be done in patients with type 2 diabetes to further look into the mechanism of an anti-diabetic drug and its effect on cardiovascular complications. 

Further studies will be needed as the population in this study was extremely small.

Practice Pearls:
  • Researchers found metformin treatment has a higher lipid metabolism profile compared to glipizide treatment in T2DM.
  • Three lipid metabolites are associated with cardiovascular complications long term. 
  • Metformin is preferred over glipizide for treatment for type 2 diabetes in patients with CVD.
Better Lipid Profile With Metformin Than With Glipizide, Diabetes Care, July 10, 2014