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Metformin‐associated prevention of weight gain in insulin‐treated type 2 diabetic patients cannot be explained by decreased energy intake: A post hoc analysis of a randomized placebo‐controlled 4.3‐year trial
Author(s) -
Out Mattijs,
Miedema Ida,
JagerWittenaar Harriët,
van der Schans Cees,
Krijnen Wim,
Lehert Philippe,
Stehouwer Coen,
Kooy Adriaan
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13054
Subject(s) - metformin , post hoc analysis , placebo , medicine , type 2 diabetes , weight gain , diabetes mellitus , endocrinology , randomized controlled trial , insulin , post hoc , body weight , alternative medicine , pathology
Metformin prevents weight gain in patients with type 2 diabetes ( T2D ). However, the mechanisms involved are still unknown. In this post hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850 mg metformin or received placebo added to insulin (1‐3 times daily) for 4.3 years. Dietary intake was assessed at baseline, after 1 year and after 4.3 years, according to the dietary history method. Among the 310 included participants, 179 (93 placebo, 86 metformin) completed all 3 dietary assessments. We found no significant difference in energy intake after 4.3 years between the groups (metformin vs placebo: −31.0 kcal/d; 95% CI , –107.4 to 45.4; F ‐value, 1.3; df = 415; P = .27). Body weight in placebo users increased significantly more than in metformin‐users during 4.3 years (4.9 ± 4.9 vs 1.1 ± 5.2 kg; t test: P ≤ .001). Linear mixed models did not show a significant effect of energy intake as explanation for the difference in weight gain between the groups ( F ‐value, 0.1; df = 1; P = .82). In conclusion, the prevention of weight gain by metformin cannot be explained by reduced energy intake.