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  • Preiss, DavidUniversity of Oxford (author)

Sustained influence of metformin therapy on circulating glucagon-like peptide-1 levels in individuals with and without type 2 diabetes

  • Article/chapterEnglish2017

Publisher, publication year, extent ...

  • 2016-12-28
  • Wiley,2017

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:5491c345-cfe5-433e-bb43-62e102bfad20
  • https://lup.lub.lu.se/record/5491c345-cfe5-433e-bb43-62e102bfad20URI
  • https://doi.org/10.1111/dom.12826DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Aims: To investigate, in the Carotid Atherosclerosis: Metformin for Insulin Resistance (CAMERA) trial (NCT00723307), whether the influence of metformin on the glucagon-like peptide (GLP)-1 axis in individuals with and without type 2 diabetes (T2DM) is sustained and related to changes in glycaemia or weight, and to investigate basal and post-meal GLP-1 levels in patients with T2DM in the cross-sectional Diabetes Research on Patient Stratification (DIRECT) study. Materials and methods: CAMERA was a double-blind randomized placebo-controlled trial of metformin in 173 participants without diabetes. Using 6-monthly fasted total GLP-1 levels over 18months, we evaluated metformin's effect on total GLP-1 with repeated-measures analysis and analysis of covariance. In the DIRECT study, we examined active and total fasting and 60-minute post-meal GLP-1 levels in 775 people recently diagnosed with T2DM treated with metformin or diet, using Student's t-tests and linear regression. Results: In CAMERA, metformin increased total GLP-1 at 6 (+20.7%, 95% confidence interval [CI] 4.7-39.0), 12 (+26.7%, 95% CI 10.3-45.6) and 18months (+18.7%, 95% CI 3.8-35.7), an overall increase of 23.4% (95% CI 11.2-36.9; P <.0001) vs placebo. Adjustment for changes in glycaemia and adiposity, individually or combined, did not attenuate this effect. In the DIRECT study, metformin was associated with higher fasting active (39.1%, 95% CI 21.3-56.4) and total GLP-1 (14.1%, 95% CI 1.2-25.9) but not post-meal incremental GLP-1. These changes were independent of potential confounders including age, sex, adiposity and glycated haemoglobin. Conclusions: In people without diabetes, metformin increases total GLP-1 in a sustained manner and independently of changes in weight or glycaemia. Metformin-treated patients with T2DM also have higher fasted GLP-1 levels, independently of weight and glycaemia.

Subject headings and genre

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  • Dawed, AdemUniversity of Dundee (author)
  • Welsh, PaulUniversity of Glasgow (author)
  • Heggie, AlisonUniversity of Newcastle upon Tyne (author)
  • Jones, Angus G.University of Exeter (author)
  • Dekker, JacquelineAmsterdam UMC - Vrije Universiteit Amsterdam (author)
  • Koivula, RobertLund University,Lunds universitet,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups(Swepub:lu)med-rkl (author)
  • Hansen, Tue H.University of Copenhagen (author)
  • Stewart, CaitlinUniversity of Glasgow (author)
  • Holman, Rury R.University of Oxford (author)
  • Franks, Paul W.Lund University,Lunds universitet,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups(Swepub:lu)med-plf (author)
  • Walker, MarkUniversity of Newcastle upon Tyne (author)
  • Pearson, Ewan R.Ninewells Hospital and Medical School (author)
  • Sattar, NaveedUniversity of Glasgow (author)
  • University of OxfordUniversity of Dundee (creator_code:org_t)

Related titles

  • In:Diabetes, Obesity and Metabolism: Wiley19:3, s. 356-3631462-8902

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