PMID- 23955995
OWN - NLM
STAT- MEDLINE
DCOM- 20140611
LR  - 20131114
IS  - 1520-7560 (Electronic)
IS  - 1520-7552 (Linking)
VI  - 29
IP  - 8
DP  - 2013 Nov
TI  - The beneficial effect of metformin on beta-cell function in non-obese Chinese 
      subjects with newly diagnosed type 2 diabetes.
PG  - 664-72
LID - 10.1002/dmrr.2443 [doi]
AB  - AIM: Studies with metformin suggest a favourable change in beta-cell function over 
      sulphonylureas in the early course of obese type 2 diabetes mellitus (T2DM), but 
      it remains unclear whether a similar effect is observed in non-obese individuals. 
      Here we investigated the effects of metformin or glipizide gastrointestinal 
      therapeutics system extended-release formulation (GITS) on beta-cell function in 
      non-obese patients with newly diagnosed T2DM. METHODS: A total of 160 newly 
      diagnosed patients with fasting glucose 7.0-13.0 mmol/L and body mass index 
      <30 kg/m(2) from five centres in China were randomized to metformin or glipizide 
      GITS for 24 weeks. Early insulin secretion [the ratio of area under the curve 
      (AUC) of insulin to glucose during 0-30 min (InsAUC30 /GluAUC30 )] and insulin 
      sensitivity [Matsuda index (ISIM )] were assessed during the standard meal 
      tolerance test before and after therapy. Plasma glucagon-like peptide-1(GLP-1) 
      and glucagon levels were also measured. RESULTS: Metformin improved InsAUC30 
      /GluAUC30 significantly (from 8.1 +/- 0.6 pmol/mmol to 10.7 +/- 0.7 pmol/mmol, 
      p < 0.05), comparable to results with glipizide GITS. In the metformin-treated 
      lean (body mass index < 25 kg/m(2) ) subgroup, the increase in ISIM was not 
      significant, but the improvement in InsAUC30 /GluAUC30 was of great magnitude. 
      Increased GLP-1 responses during meal tolerance test and decreased fasting 
      glucagon level were observed after metformin treatment. Correlation analysis 
      showed that the improvement of InsAUC30 /GluAUC30 was associated with the changes 
      in HbA1c (r = -0.374, p = 0.000), ISIM (r = 0.356, p = 0.001), and DeltaGLP-10-30 
      (r = 0.225, p = 0.02). CONCLUSIONS: Metformin improved beta-cell function in 
      non-obese subjects with newly diagnosed T2DM, which was partly independent of the 
      change in insulin sensitivity in these subjects. This study provides 
      evidence-based data to support metformin use in non-obese patients with T2DM as 
      the first-line agent, which can improve both insulin sensitivity and beta-cell 
      function.
CI  - Copyright (c) 2013 John Wiley & Sons, Ltd.
FAU - Bi, Y
AU  - Bi Y
AD  - Department of Endocrinology, Drum Tower Hospital affiliated to Nanjing University 
      Medical School, Nanjing, China; Drum Tower Clinical Medical College of Nanjing 
      Medical University, Nanjing, China.
FAU - Tong, G Y
AU  - Tong GY
FAU - Yang, H J
AU  - Yang HJ
FAU - Cai, M Y
AU  - Cai MY
FAU - Ma, J H
AU  - Ma JH
FAU - Liang, J
AU  - Liang J
FAU - Xin, B
AU  - Xin B
FAU - Miao, H
AU  - Miao H
FAU - Peng, Z H
AU  - Peng ZH
FAU - Zhu, D L
AU  - Zhu DL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Diabetes Metab Res Rev
JT  - Diabetes/metabolism research and reviews
JID - 100883450
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Hypoglycemic Agents)
RN  - 9100L32L2N (Metformin)
RN  - X7WDT95N5C (Glipizide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Area Under Curve
MH  - Delayed-Action Preparations
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Glipizide/therapeutic use
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin-Secreting Cells/*drug effects
MH  - Male
MH  - Metformin/*therapeutic use
MH  - Middle Aged
MH  - Treatment Outcome
OTO - NOTNLM
OT  - beta cell function
OT  - glucagon
OT  - glucagon-like peptide-1
OT  - metformin
OT  - non-obese
OT  - type 2 diabetes mellitus
EDAT- 2013/08/21 06:00
MHDA- 2014/06/12 06:00
CRDT- 2013/08/20 06:00
PHST- 2013/02/27 00:00 [received]
PHST- 2013/07/08 00:00 [revised]
PHST- 2013/07/14 00:00 [accepted]
PHST- 2013/08/20 06:00 [entrez]
PHST- 2013/08/21 06:00 [pubmed]
PHST- 2014/06/12 06:00 [medline]
AID - 10.1002/dmrr.2443 [doi]
PST - ppublish
SO  - Diabetes Metab Res Rev. 2013 Nov;29(8):664-72. doi: 10.1002/dmrr.2443.