Glucose lowering is greater when metformin is given before rather than with enteral glucose; this is also linked to greater GLP-1 response<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b><\/p>\n
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FRIDAY, June 21, 2024 (HealthDay News) — Glucose lowering by metformin is greater when given before enteral glucose among patients with type 2 diabetes controlled by metformin monotherapy, according to a study recently published in Diabetologia<\/em>.<\/p>\n Cong Xie, Ph.D., from the University of Adelaide in Australia, and colleagues studied 16 participants with type 2 diabetes that was relatively well controlled by metformin monotherapy on four separate days. Participants were randomly assigned on each day to receive a bolus infusion of metformin via a nasoduodenal catheter at \u00e2\u0088\u009260, \u00e2\u0088\u009230, or 0 minutes (saline at other time points) or saline at all time points (control) followed by an intraduodenal glucose infusion at 0 to 60 minutes.<\/p>\n The researchers identified a treatment-by-time interaction for metformin in terms of reducing plasma glucose levels and increasing plasma glucagon-like peptide 1 (GLP-1) and insulin levels. A greater reduction in plasma glucose levels was seen when metformin was administered at \u00e2\u0088\u009260 or \u00e2\u0088\u009230 minutes versus 0 minutes; the increases in plasma GLP-1 were only seen when metformin was administered at \u00e2\u0088\u009260 or \u00e2\u0088\u009230 minutes. Metformin enhanced glucose-induced insulin secretion, although it did not influence insulin sensitivity; on the three days when metformin was given, the increases in plasma insulin levels were comparable.<\/p>\n “Metformin is more effective in glucose-lowering when given before, rather than with, enteral glucose, and this is associated with a greater GLP-1 response,” the authors write.<\/p>\n Several authors disclosed ties to the pharmaceutical industry.<\/p>\n