Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo 133-0052, Japan.
Nutr Metab (Lond). 2010 Nov 12;7:83. doi: 10.1186/1743-7075-7-83.
We aimed to investigate the long-term effect of metformin on the blood glucose control in non-obese patients with type 2 diabetes mellitus.
A retrospective study was performed in 213 patients with type 2 diabetes mellitus under the administration of metformin for more than one year. The clinical parameters were investigated for 3 years. The obese and non-obese individuals were defined as a body mass index (BMI) of 25 kg/m2 or over (n = 105) and a BMI of less than 25 kg/m2 (n = 108), respectively.
HbA1c levels were significantly decreased compared with those at the baseline time. The course of HbA1c was similar between the non-obese and the obese groups, while the dose of metformin required to control blood glucose was significantly lower in the non-obese group than in the obese group. The reductions in HbA1c were 1.2% and 1.1% at 12 months, 0.9% and 0.9% at 24 months, and 0.8% and 1.0% at 36 months in the non-obese and obese groups, respectively. BMI did not change during the observation periods. Approximately half of all patients required no additional antidiabetic agents or a reduction in other treatments after the initiation of metformin in either of the two groups.
The present study demonstrated the long-term beneficial effect of metformin in non-obese (BMI < 25 kg/m2) diabetic patients. This effect appears to be maintained even after the observation period of this study, because metformin was limited to a relatively low dose in the non-obese group and the observed worsening in glycemic control over time can probably be attenuated by increasing the dose of metformin.
本研究旨在探讨二甲双胍对非肥胖 2 型糖尿病患者血糖控制的长期影响。
本研究采用回顾性研究方法，对 213 例服用二甲双胍超过 1 年的 2 型糖尿病患者进行了研究。对患者的临床参数进行了 3 年的随访。将肥胖和非肥胖患者定义为体重指数（BMI）≥25kg/m2（n=105）和 BMI<25kg/m2（n=108）。
与基线时相比，HbA1c 水平显著降低。非肥胖组和肥胖组的 HbA1c 变化过程相似，但非肥胖组控制血糖所需的二甲双胍剂量明显低于肥胖组。12 个月时，HbA1c 分别降低了 1.2%和 1.1%，24 个月时分别降低了 0.9%和 0.9%，36 个月时分别降低了 0.8%和 1.0%。观察期间 BMI 无变化。两组患者中，约一半的患者在起始服用二甲双胍后无需加用其他降糖药物或减少其他治疗。
本研究表明，二甲双胍对非肥胖（BMI<25kg/m2）糖尿病患者具有长期的有益作用。这种作用在本研究的观察期后似乎仍然存在，因为非肥胖组的二甲双胍剂量相对较低，而随着时间的推移血糖控制恶化，可能通过增加二甲双胍的剂量来减轻。
