Researchers at the University of Adelaide may be close to finding a better way to use metformin, a common type 2 diabetes drug.
Metformin, a cornerstone of diabetes treatment since the 1960s, is typically taken with food to reduce gastrointestinal side effects, but new research suggests that patients may see benefits if they take the drug before meals.
Dr Kong Shi, a postdoctoral research fellow at the Centre of Research Excellence in Linking Nutrition Science to Health at the Adelaide Medical School, worked with Associate Professor Tongji Wu and team to study the gastrointestinal effects of the drug in 16 people with type 2 diabetes who were already using it to treat their diabetes.
Their findings have been published in the journal Diabetologia and are now being used in e-learning for the European Society for the Study of Diabetes, one of the largest international platforms for diabetes research and clinical practice.
“Our results show that administering metformin 30 to 60 minutes before a meal reduces plasma glucose concentrations and increases secretion of the incretin hormone glucagon-like peptide 1 (GLP-1) and insulin concentrations,” said Dr. Xie.
“GLP-1 is a hormone secreted from the intestine that exerts a variety of beneficial effects on blood glucose and weight control, including appetite suppression, insulin stimulation, delayed gastric emptying, and promotion of glucose absorption in the intestine.”
“Many GLP-1-based drugs are currently in clinical use to manage obesity and type 2 diabetes, and these drugs also reduce the risk of cardiovascular disease.”
Dr. Xie said plasma GLP-1 concentrations increased only when subjects were given metformin before the glucose infusion, not at the same time.
“This suggests that changes in blood glucose-gut interactions are affecting blood glucose levels,” he said.
Associate Professor Wu said the study found no substantial difference in patients’ nausea scores depending on the time of administration.
“Our findings suggest that the empirical recommendation to take metformin with meals may undermine metformin’s effectiveness in improving postprandial glycemic control,” he said.
“Changing the timing of metformin intake in relation to meals may be a cost-effective approach to improve glycemic control in patients with type 2 diabetes.”
“We now plan to expand this study to the real world to see whether administering metformin before meals improves glycemic control in people with type 2 diabetes in the long term.”
