Metformin : as First-Line Treatment for Type 2 Diabetes Prevention

Abstract

Objectives: To assess the effect of Metformin, this has multiple pharmacodynamic effects and prevention
in type 2 diabetes (T2DM).
Design: Case - control study.
Setting: Outpatient clinics of Diabetic Endocrine Research Lab and patients reporting to medicine department
of Sheth Vadilal Sarabhai General Hospital ( Smt. NHL Municipal Medical College ) , Ahmedabad, Gujarat .
Participants: A total of 240 patients, 100 control group healthy normal and nondiabetic 140 study group with
Type 2 Diabetes treated with Metformin and not known with a contraindication for the use of Metformin
were approached, given informed consent, and entered the study.
e .Intervention : Addition of Metformin to Insulin Therapy three times a day.
Primary Outcomes: Vitamin B12, Folic acid , Serum Homocysteine.
Results : Metformin Treatment compare with control, was associated with a mean difference in Vitamin
B12 -340.26 and confidence 6.71 ( 95 % confidence interval 27.53 to 40.95: P= < 0.0001) , and in Folate
concentration of -6.24 and confidence 0.18 ( 95% confidence interval 0.74 to 1.1:P=0.026 ) , and an increase
in Homocysteine concentration of 18.97 and confidence 0.93 ( 95% confidence interval 3.83 to 5.69 : P=
<0.0001 ) . In addition, decrease Vitamin B12 and Folate could be explained by the increase in Homocysteine.
The average person with type 2 DM has 3 times the normal rate of gluconeogenesis, Metformin treatment
reduces this by over one – third.
Conclusion : Metformin use for long term has been associated with increased homocysteine level and
malabsorption of Vitamin B12 which is preventable and some researchers and our findings suggests ,
recommend screening or prevention strategies .Metformin’s efficacy, security, profile, benefic Cardio
Vascular & metabolic effects, and its capacity to be associated with other antidiabetic agents makes this
drug the first glucose lowering agent of choice when treating patients with T2DM.