Abstract
Biguanides (phenoformin) have not been recently used to treat patients because of a high frequency of lactic acidosis (0.25-1 case per 1, 000 patients-years) and related deaths. The latest reports have stressed that biguanides metformin has no effect on pancreatic insulin secretion, including the decreased intestinal absorption of glucose, decreased glucose production in the liver, and improved lipid profile and, as a result, this drug is now being reevaluated. A retrospective study was carried out to assess the clinical effect of metformin in medication counseling. Using diabetic (NIDDM) outpatients whose treatment included the administration of metformin, the authors conducted a survey on the results of glycemic controls, weights, and serum lipid levels before and after an 8-week administration of the drug based on the patients' medical records at Aichi Medical University Hospital. The subjects consisted of a metformin group (M group; 10 cases) in whom the drug alone administrated as an antihyperglycemic agent. The results of this group were comparde wih those of a group receiving metformin in combination with sufonylureas (MS group ; 12 cases) based on a statistical analysis of the relevant factors. In the M group, the HbAlc concentration did not change (from 8.3±1.2% to 8.3±1.4%), but the HDL-C level significantly decreased (p<0.05). The MS group showed that the HbAlc concentration (from 9.9±2% to 8.8±1.4%), TG level, and HDL-C level all significantly improved (p< 0.05). The body weight and the serum lactic acid level were not significantly changed in either group before and after the administration of metformin. The results of this investigation indicated that metformin may thus be useful as an add-on therapy in patients with diabetes controlled by sulfonylu reas. In addition, it is particularly effective in obese patients with insulin resistance while also having a favorable impact on the lipid profiles.
