Once Daily ER Metformin Safe and Effective in Type 2 Diabetes

A single daily dose of 2000 mg. was shown to be effective in decreasing fasting plasma glucose levels. One daily dose of a new extended-release formulation of metformin is as safe and effective in treating type 2 diabetes as a conventional twice-a-day dose of immediate-release metformin, researchers report.

Co-author Dr. Bret Berner stated that, "With this extended-release formula, you can give the patients up to 2000 mg a day, which had not yet proven effective with other drugs."

"The new drug seems to improve the rapidity of initial titration but also patients’ tolerability for higher doses, which might influence their adherence," said Dr. Berner, who is chief scientific officer and vice president of product development at Menlo Park, California-based Depomed, the maker of the extended-release metformin (Glumetza).

To determine the efficacy and safety of the medication, 700 type 2 diabetic patients were assigned to receive one of four treatments during 24 weeks: extended-release metformin at 1,500 mg once a day; extended-release metformin, 500 mg in the morning and 1000 mg at night; extended-release metformin in a single daily dose of 2000 mg; or 1,500 mg of immediate-release metformin twice daily.

By the end of the 12th week, mean levels of HbA1c had dropped significantly in all groups, the authors report.
At the end of week 24, the drops in both groups given 1,500 mg extended-release metformin were not significantly different from the drop observed in the immediate-release metformin group (-0.73%, -0.74%, and -0.70%, respectively). On the other hand, HbA1c levels dropped 1.06% in the group given a single dose of 2000 mg extended-release metformin.

These results differ from those obtained with other extended-release metformin formulations, when the once-daily treatments tended to be less effective than the twice-daily treatments, the researchers point out.

Rapid decreases in fasting plasma glucose levels also occurred, at week 1 and maintained throughout the current study.
The overall incidence of adverse events was similar for all treatment groups, said Dr. Berner, which implies that a single 2000-mg dose of extended-release metformin is well tolerated by most patients.
Diabetes Care 2006;29:759-764.

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FACT:
Diet: 700,000 children in UK are obese: Over-eating and a lack of exercise mean Britain’s young people are storing up serious health problems. More than half a million British schoolchildren are obese, according to a major new study by the London-based International Obesity Taskforce, that warns of soaring rates of diabetes, liver failure and heart problems among the young. Researchers say that about 160,000 children are displaying signs that they will develop heart disease. At least 150,000 have high blood pressure and high cholesterol levels. And a similar number are likely to develop liver disease early in life. The research also shows for the first time that there are signs of Type 2 (late onset) diabetes in 4,000 children. The disease is normally associated with old age, but the researchers warn that it could strike 60,000 youngsters in the near future.

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