Optimization of Metformin in the GRADE Cohort: Effect on Glycemia and Body Weight.

Diabetes Care
William I SivitzGRADE Research Group

Abstract

We evaluated the effect of optimizing metformin dosing on glycemia and body weight in type 2 diabetes. This was a prespecified analysis of 6,823 participants in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) taking metformin as the sole glucose-lowering drug who completed a 4- to 14-week (mean ± SD 7.9 ± 2.4) run-in in which metformin was adjusted to 2,000 mg/day or a maximally tolerated lower dose. Participants had type 2 diabetes for <10 years and an HbA1c ≥6.8% (51 mmol/mol) while taking ≥500 mg of metformin/day. Participants also received diet and exercise counseling. The primary outcome was the change in HbA1c during run-in. Adjusted for duration of run-in, the mean ± SD change in HbA1c was -0.65 ± 0.02% (-7.1 ± 0.2 mmol/mol) when the dose was increased by ≥1,000 mg/day, -0.48 ± 0.02% (-5.2 ± 0.2 mmol/mol) when the dose was unchanged, and -0.23 ± 0.07% (-2.5 ± 0.8 mmol/mol) when the dose was decreased (n = 2,169, 3,548, and 192, respectively). Higher HbA1c at entry predicted greater reduction in HbA1c (P < 0.001) in univariate and multivariate analyses. Weight loss adjusted for duration of run-in averaged 0.91 ± 0.05 kg in participants who increased metformin by ≥1,000 mg/day (n = ...Continue Reading

References

Nov 14, 2003·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·A Holstein, E-H Egberts
Sep 12, 2008·The New England Journal of Medicine·Rury R HolmanH Andrew W Neil
Jun 4, 2010·Diabetes Care·Ragnar HanasUNKNOWN International HBA1c Consensus Committee
Mar 15, 2010·World Journal of Diabetes·Claudia FilozofJames E Foley
Jan 26, 2012·Diabetes Care·Jennifer A HirstRichard J Stevens
Apr 25, 2013·Clinical Chemistry and Laboratory Medicine : CCLM·Ragnar HanasUNKNOWN International HbA₁c Consensus Committee
May 22, 2013·Diabetes Care·David M NathanUNKNOWN GRADE Study Research Group
Jun 13, 2014·The Journal of Clinical Endocrinology and Metabolism·L Keoki WilliamsDavid E Lanfear
Jun 11, 2015·Drugs·Ulrike HostalekSteven Hildemann
Feb 24, 2016·The Journal of Clinical Endocrinology and Metabolism·Vanita R ArodaUNKNOWN Diabetes Prevention Program Research Group
Aug 5, 2017·Diabetologia·Clifford J Bailey
Nov 15, 2017·Diabetes, Obesity & Metabolism·Andrew McGovernSimon de Lusignan
Dec 10, 2017·Diabetes Care·UNKNOWN American Diabetes Association
Dec 10, 2017·Diabetes Care·UNKNOWN American Diabetes Association
Jan 13, 2018·The Journal of Clinical Endocrinology and Metabolism·Po-Kai YangHong-Nerng Ho
May 31, 2018·JAMA : the Journal of the American Medical Association·Jennifer Abbasi
Jun 21, 2018·JAMA : the Journal of the American Medical Association·Elizabeth L TungNeda Laiteerapong

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Citations

Jan 26, 2021·Therapeutic Advances in Endocrinology and Metabolism·Chelsea BakerNeda Rasouli
Aug 5, 2021·Clinical Medicine Insights. Endocrinology and Diabetes·Ashok Kumar DasSantosh Revankar
Jul 25, 2021·International Journal of Molecular Sciences·Chunye Zhang, Ming Yang

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