Unique glycemic and cardio-renal protective effects of metformin therapy among type-2 diabetic patients: a lesson from a five-year cross-sectional observational study of 1590 patients

What is it about?

Metformin is currently considered as a first-line therapy for managing type-2 diabetes for targeting insulin resistance and obesity. However, in the usual busy clinical practice, the importance of metformin is sometimes ignored and patients are prescribed directly oral hypoglycemic agents (OHA) or shifted to insulin therapy without metformin. Metformin has been shown to counteract dyslipidemia and to function as a drug for cardiac and renal protection as well. Current research was planned to enroll type-2 patients who were either additionally prescribed metformin (with other OHA/insulins) or not on metformin; and to compare HbA1c lipids, creatinine, spot urine protein and spot urine protein/creatinine between these two groups. The study included 1590 patients and data were collected for a period of 5 years (January 2009 till January 2014) in the diabetology clinic of Aseer Diabetes Center. Children (<13 years), pregnant women, patients with type-1 diabetes mellitus (DM), chronic renal failure, end stage renal disease (ESRD), and patients who were intolerant to metformin were excluded. It was observed that 581 (36.6%) type-2 DM subjects were not prescribed metformin. Levels of HbA1c and BMI were lower in the metformin group than those without metformin (9.47 ± 2 and 27.35 versus 9.74± 2.4 and 30.25 ± 5.72; p-values 0.004 and < 0.0001, respectively). Non-HDL cholesterol values were higher for the metformin group (152.6 ± 48 versus 140.4 ± 44; p <0.0001). Levels of creatinine, spot urine protein and spot urine protein/creatinine were higher for the group without metformin therapy (1.1 ± 0.31, 95.23 ± 138, 1.143 ± 3.39 versus 0.89 ± 0.2, 38.92 ± 82.17, 0.425 ± 1.25 with p-values <0.0001, 0.017 and 0.015, respectively). In the current study, metformin provided unique glycemic and lipid control and cardio-renal protection among type-2 DM patients and should be prescribed to type-2 DM patients to prevent complications of diabetes.

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