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Short Administration of Metformin Improves Insulin Sensitivity in Android Obese Subjects with Impaired Glucose Tolerance
Author(s) -
Scheen A.J.,
Letiexhe M.R.,
Lefèbvre P.J.
Publication year - 1995
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1995.tb00410.x
Subject(s) - medicine , metformin , endocrinology , insulin , area under the curve , insulin resistance , impaired glucose tolerance , type 2 diabetes , c peptide , glucose tolerance test , diabetes mellitus
In a double‐blind, randomized, cross‐over study, the metabolic effects of a short treatment with metformin (2 times 850 mg day −1 for 2 days and 850 mg 1 h before evaluation) were compared to those of placebo in 15 obese subjects (BMI: 33.2 ± 0.9 kg m −2 ), with abdominal distribution of adipose tissue and impaired glucose tolerance. An intravenous glucose tolerance test (0.3 g glucose kg −1 ) was performed after each period of treatment. Areas under the curve (AUC 0–180 min ) were calculated for plasma glucose, insulin, and C‐peptide levels. Glucose tolerance was estimated by the coefficient of glucose assimilation ( K G ). Insulin sensitivity ( S I ) and glucose effectiveness ( S G ) indices were calculated using Bergman's minimal model. Insulin secretion rate (ISR) was determined by deconvolution of plasma C‐peptide levels and insulin metabolic clearance rate (MCR) was estimated by dividing AUC ISR by AUC insulin. Fasting plasma insulin levels were reduced after metformin (89.3 ± 15.9 vs 112.4 ± 24.3 pmol I −1 ; p = 0.04). AUC glucose, K G and S G were similar in both tests. However, AUC insulin was reduced (39.7 ± 6.5 vs 51.8 ± 10.4 nmol min I −1 ; p = 0.02), while S I (6.98 ± 1.14 vs 4.61 ± 0.42 10 −5 min −1 pmol −1 I; p = 0.03) and insulin MCR (715 ± 116 vs 617 ± 94 ml min −1 m −2 ; p = 0.03) were increased after metformin. The demonstration that metformin rapidly improves insulin sensitivity should encourage further research to evaluate the long‐term effects of metformin in android obese subjects with impaired oral glucose tolerance.