Take metformin before meals to improve triglyceride control, study suggests
Preprandial administration of metformin successfully and safely reduces postprandial plasma triglyceride levels, a new study has shown.
Eleven patients (mean age 53.5±12.9 years; nine men) were randomly assigned to receive metformin either 30 minutes before a test meal or 15 minutes after. A meal test, involving cookies containing 75 g of carbohydrate, was performed to investigate the difference in effect between preprandial and postprandial administration of metformin on postprandial hypertriglyceridaemia.
The mean body mass index (BMI) was 27.9 kg/m2, while the mean nonfasting plasma triglyceride concentration was 275.9±189.0 mg/dL. Eight participants were given 750 mg of single-dose metformin, while the remaining three received a single 500-mg dose.
Relative to postprandial administration, taking metformin before the meal test resulted in slightly lower postprandial triglyceride levels. The area under the curve for the 0–4-hour concentration of triglycerides was significantly lower in the pre- vs postprandial administration protocol (p=0.032).
Blood glucose levels also tended to be reduced in the first 180 minutes after meal test, but was significantly elevated in the preprandial protocol at 240 minutes (p=0.048).
Using a visual analogue scale, participants in the preprandial metformin protocol reported significantly increased meal satiety compared with those who were given the medication after the meal test (p=0.036). There were no significant between-group differences in terms of negative gastrointestinal symptoms, such as heartburn and stomach heaviness.
The present findings indicate that simply changing the timing of metformin medication may improve triglyceride control among type 2 diabetes mellitus patients, said researchers.