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Comparison of gastrointestinal adverse events with different doses of metformin in the treatment of elderly people with type 2 diabetes
Author(s) -
Yuxin Huang,
Cuiping Jiang,
Wen Tan,
Jieyuzhen Qiu,
Xiaoming Tao,
Qin Gu,
Haidong Wang,
Jiao Sun,
Zhijun Bao
Publication year - 2020
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.13087
Subject(s) - metformin , medicine , nausea , adverse effect , vomiting , type 2 diabetes , diabetes mellitus , abdominal pain , bloating , anorexia , gastroenterology , diarrhea , insulin , endocrinology
What is known and Objective Gastrointestinal discomfort is the most common adverse event of metformin treatment for type 2 diabetes, especially in elderly patients. The aim of this study was to compare gastrointestinal adverse events resulting from different doses of metformin used for the treatment of elderly people with type 2 diabetes. Methods A total of 361 elderly patients with newly diagnosed diabetes were randomly divided into three groups: metformin 1000 mg/d (N = 120), metformin 1500 mg/d (N = 121) and metformin 2000 mg/d (N = 120). Glycaemic control and gastrointestinal adverse events (abdominal pain, diarrhoea, nausea, vomiting, bloating and anorexia) were assessed and compared among the three groups after 12 weeks of treatment. Results and discussion At baseline, there was no significant difference in gastrointestinal symptoms among the three groups. After 12 weeks of treatment with metformin, the change in HbA 1c level was −0.7%, −0.9% and −1.0% for the 1000 mg/d, 1500 mg/d and 2000 mg/d groups, respectively ( P < .0001). There was no significant difference in gastrointestinal adverse events among the three groups after treatment with metformin. In total, 62 people (17.2%) could not tolerate the adverse effects of metformin, and most of them stopped treatment in the first 4 weeks. Logistic regression analysis shows that female sex (OR = 2.660, 95%CI 1.692‐4.183, P < .0001) and the concurrent use of organic cation transporter 1‐inhibiting drugs (OR = 1.874, 95%CI 1.076‐3.265, P = .027) are independent risk factors for adverse events. What is new and conclusions Our data demonstrate that metformin doses of 1000 mg/d‐2000 mg/d have similar adverse events but that 2000 mg/d of metformin yields the best glycaemic control in elderly people with diabetes. If elderly people can tolerate 1000 mg/d of metformin, we could gradually increase the dose to 2000 mg/d to achieve better glycaemic control.