Metformin Plus Insulin improves Glycemic Control and Reduces Weight Gain

Type 2 patients who require insulin treatment, continuing metformin treatment reduced weight gain and insulin requirement, and improved glycemic control. Researchers reported the effects of continued metformin treatment on weight gain and glycemic control in patients with type 2 diabetes who required insulin treatment (2). A total of 183 patients who were referred for insulin treatment were randomized to metformin, titrated up to 2g daily or the maximum tolerated dose, or placebo, and insulin according to local standard practice. Weight change, HbA1c, insulin dose, hypoglycemia, treatment satisfaction, and patient well-being were measured over 12 months.

The investigators found that, after 12 months, patients taking metformin had less weight gain than those taking placebo (mean 6.1kg vs 7.6kg; p=0.02). Metformin produced a greater reduction in HbA1c (1.5% vs 1.3%; p=0.02) and reduced the insulin requirement (62 units vs 86 units; p<0.001). Those taking metformin, however, had an increased relative risk of hypoglycemic episodes (1.24; p=0.03). Scores for patient treatment satisfaction and well-being improved more in the metformin group than in the placebo group (p<0.001 and p=0.02, respectively).

The investigators concluded that, for patients with type 2 diabetes who require insulin treatment, continuing metformin treatment reduced weight gain and insulin requirement, and improved glycaemic control. In the May issue of Diabetic Medicine Professor Polly Bingley of the Southmead Hospital in Bristol, UK, and his colleagues
Diabetic Medicine 2005; 22: 634-40

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FACT:
DIET SODAS ARE NO SALVATION FOR THE OVERWEIGHT: As the U.S. population has grown increasingly overweight, the marketing of diet products to help control weight has burgeoned. But do diet sodas help reduce obesity? The San Antonio Heart Study took a closer look (#1058). The opposite was true. The group that drank diet soda had the highest incidence of overweight, compared to those who drank only regular soft drinks (lowest incidence) and those who drank half of one, half of the other (in between). This "raises questions about the advisability of reliance on these products for weight control," say the authors.

ADA 65th Annual Scientific Sessions: Abstract 1058, Presented June 12, 2005.