Faculty of Physical Education and Recreation, 1-002 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, AB, Canada, T6G 2E1,
Diabetologia. 2013 Nov;56(11):2378-82. doi: 10.1007/s00125-013-3026-6. Epub 2013 Aug 23.
AIMS/HYPOTHESIS: Some previous studies suggested that metformin might attenuate the effects of exercise on glycaemia or fitness. We therefore examined whether metformin use influenced changes in glycaemic control, fitness, body weight or waist circumference resulting from aerobic and/or resistance training in people with type 2 diabetes participating in an exercise intervention trial.
After a 4 week run-in period, participants from the Diabetes Aerobic and Resistance Exercise (DARE) trial were randomly assigned to 22 weeks of aerobic training alone, resistance training alone, combined aerobic and resistance exercise training or a waiting-list control group. Of the 251 randomised, 143 participants reported using metformin throughout the entire study period and 82 reported not using metformin at all.
Compared with control, aerobic training led to a significant reduction in HbA1c in the metformin users (-0.57%, 95% CI -1.05, -0.10; -6.3 mmol/mol, 95% CI -11.5, -1.1) but not in the non-metformin users (-0.17, 95% CI -0.78, 0.43; -1.9 mmol/mol, 95% CI -8.5, 4.7). However, there were no significant differences in the changes in HbA1c (or fasting glucose) between metformin users and non-users in any of the exercise groups compared with control (p> 0.32 for all metformin by group by time interactions). Similarly, metformin did not affect changes in indicators of aerobic fitness, strength and body weight or waist circumference (p ≥ 0.15 for all metformin by group by time interactions).
CONCLUSIONS/INTERPRETATION: Contrary to our hypothesis and to previous short-term studies, metformin did not significantly attenuate the benefits of exercise on glycaemic control or fitness.
目的/假设：一些先前的研究表明，二甲双胍可能会减弱运动对血糖或健康的影响。因此，我们研究了二甲双胍的使用是否会影响 2 型糖尿病患者在参加运动干预试验中接受有氧和/或抗阻训练后血糖控制、健康状况、体重或腰围的变化。
在 4 周的适应期后，糖尿病有氧和抗阻运动（DARE）试验的参与者被随机分为单独进行 22 周的有氧运动、单独进行抗阻运动、有氧和抗阻运动联合训练或等待名单对照组。在 251 名随机分组的参与者中，有 143 名报告在整个研究期间使用了二甲双胍，82 名报告完全没有使用二甲双胍。
与对照组相比，有氧运动使二甲双胍使用者的 HbA1c 显著降低（-0.57%，95%CI-1.05，-0.10；-6.3mmol/mol，95%CI-11.5，-1.1），而非二甲双胍使用者则无明显变化（-0.17，95%CI-0.78，0.43；-1.9mmol/mol，95%CI-8.5，4.7）。然而，与对照组相比，在任何运动组中，二甲双胍使用者和非使用者之间的 HbA1c（或空腹血糖）变化均无显著差异（所有二甲双胍与组间时间交互作用的 p 值>0.32）。同样，二甲双胍也不会影响有氧运动能力、力量和体重或腰围的变化（所有二甲双胍与组间时间交互作用的 p 值≥0.15）。
结论/解释：与我们的假设和之前的短期研究相反，二甲双胍并没有显著减弱运动对血糖控制或健康的益处。
