Patients with young onset diabetes are more sensitive to metformin
Young onset type 2 diabetes (YOD) patients appear to be more responsive to metformin, requiring significantly lower insulin with metformin add-on doses than late onset type 2 diabetes (LOD) patients to achieve glycaemic control, a recent study has revealed.
Researchers retrieved medical data of 188 patients who participated in two prior randomized, controlled open-label trials, in which participants received continuous subcutaneous insulin infusion (CSII) with or without metformin.
In the present study, newly diagnosed patients were divided according to age of diabetes onset: before 40 years (YOD; n=36) and after 40 (LOD; n=152). The primary study endpoint was the difference in insulin doses between the two groups.
The time to achieve euglycaemic control was similar between the YOD and LOD groups (4.8±2.4 vs 5.1±2.3 days, respectively). Respective total (0.45±0.27 vs 0.51±024 U/kg/day), basal (0.25±0.17 vs 0.27±0.13 U/kg/day) and bolus (0.22±0.14 vs 0.24±0.16 U/kg/day) insulin doses to maintain glycaemic control were also comparable between groups.
In contrast, those who received CSII with metformin required significantly lower total (0.32±0.15 vs 0.61±0.30 U/kg/day), basal (0.18±0.09 vs 0.33±0.20 U/kg/day) and bolus (0.15±0.06 vs 0.28±0.16 U/kg/day; p<0.01 for all) insulin doses to maintain glycaemic control than those who received insulin alone.
Notably, the total insulin dose required to maintain glycaemic control was also significantly lower in YOD patients on metformin combination therapy than their LOD counterparts (0.32±0.15 vs 0.43±0.15; U/kg/day; p<0.05).
“The data of this current study indicated that newly diagnosed [type 2 diabetes] patients with YOD had a significant increase in metformin sensitivity, which manifested itself when lowering insulin doses to maintain glycaemic control compared to those with a later age of onset of diabetes,” researchers said.