diabetestalk.net

Metformin Coronary Artery Disease

Metformin Lowers Risk Of Heart Disease And Mortality

Metformin Lowers Risk Of Heart Disease And Mortality

Not only is metformin the oldest diabetes drug, it is also still the first choice for diabetes treatment. Dr. Nils Ekström of the University of Gothenburg in Sweden, and colleagues set out to study the safety and effectiveness of metformin in a large group of men and women with type 2 diabetes. They found that type 2 diabetes patients taking metformin may have a lower risk of heart disease and death, compared to patients on insulin. These findings suggest that metformin has a lower risk of side effects than other common diabetes drugs. The study included more than 51,000 patients with type 2 diabetes. Patients taking metformin also had a slightly lower risk of death compared to patients taking oral hypoglycemic agents. Metformin was first created and found to lower blood sugar levels in the 1920s and approved for use in the U.S. in 1950. Almost a century later, it is still a first-line treatment for type 2 diabetes. On top of finding that patients taking metformin had a lower risk of heart disease and death, the researchers found that patients with weakened kidney function did not have an increased risk of heart disease, death or serious infection. Other findings showed that metformin, compared to any other treatment, was associated with a lower risk of acidosis (too much acid in the body fluids) and serious infection among patients with an estimated Glomerular Filtration Rate, or eGFR (a measure of kidney function), of 45 to 60. Among patients with an eGFR of 30 to 45, metformin had no increased risk of all-cause mortality, acidosis, serious infection or heart disease. An eGFR of 60 and above is considered normal. Kidney disease is marked by an eGFR below 60. Kidney failure is marked by an eGFR of 15 or below. Metformin was also associated with a lower all-cause morta Continue reading >>

Metformin Reduces Left Ventricular Mass In Patients With Ischemic Heart Disease

Metformin Reduces Left Ventricular Mass In Patients With Ischemic Heart Disease

You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Metformin Reduces Left Ventricular Mass in Patients With Ischemic Heart Disease The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT01879293 Wuhan General Hospital of Guangzhou Military Command Information provided by (Responsible Party): Xiang Guang-da, Wuhan General Hospital of Guangzhou Military Command Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Cardiovascular disease is the most common cause of death in the world. Most of the attention in treating ischemic heart disease (IHD) is understandably directed toward treating coronary artery disease. However there are other treatable culprits in these patients. Left ventricular hypertrophy (LVH) is widespread in IHD patients, even in the absence of hypertension. It is a strong predictor of cardiovascular events and all-cause mortality. In one study, the presence of LVH was a stronger predictor of mortality than either multivessel cor-onary disease or impaired LV function. Metformin is an antihyperglycemic agent with a history of successful use in type 2 diabetes. In the UKPDS (United Kingdom Prospective Diabetes Study), metformin was associated with a 39% lower risk of myocardial infarction compared with conventional therapy. Metformin also offered dual benefits of improving vascular function and lessening ischemia in nondiabetic patients. Hence, the main aim of this study was to assess whether metformin c Continue reading >>

Metformin Superior To Glipizide For Reducing Cvd Events In Diabetics With Cad

Metformin Superior To Glipizide For Reducing Cvd Events In Diabetics With Cad

SHANGHAI, China The use of metformin significantly reduced the risk of cardiovascular events among diabetic patients with coronary artery disease when compared with the sulfonylurea glipizide, according to the results of a randomized clinical trial [1]. Over a median follow-up of five years, treatment with metformin reduced the primary composite end point of death from cardiovascular causes, death from any cause, nonfatal MI, nonfatal stroke, and arterial revascularization by 46% compared with glipizide. The researchers also performed a second analysis examining only cardiovascular events that occurred after one year of treatment--performed to ensure that the cardiovascular events were not caused by the antidiabetic drugs--and found a significant 52% relative reduction in the risk of cardiovascular events. Led by Dr Jie Hong (Shanghai Jiao Tong University School of Medicine, China), the study, known as the Study on the Prognosis and Effect of Antidiabetic Drugs on Type 2 Diabetes Mellitus with Coronary Artery Disease (SPREAD-DIMCAD), is published December 10, 2012 in Diabetes Care. The trial included 304 patients with type 2 diabetes and coronary artery disease randomly assigned to glipizide 30 mg or metformin 1.5 mg for three years. Patients had been diagnosed with diabetes for more than five years and with coronary artery disease for three years. In total, there were 103 primary composite events in 91 patients, including 52 patients in the glipizide arm and 39 patients in the metformin arm. There were 60 clinical events in the glipizide-treated patients, including 14 deaths from all causes (11 deaths from cardiovascular causes and three from sudden death), six MIs, 15 nonfatal strokes, and 25 arterial revascularizations. In the metformin arm, there were 43 clinical e Continue reading >>

Effect Of Metformin And Lifestyle On Coronary Artery Calcium

Effect Of Metformin And Lifestyle On Coronary Artery Calcium

Effect of Metformin and Lifestyle on Coronary Artery Calcium Goldberg RB, Aroda VR, Bluemke DA, et al., on behalf of the Diabetes Prevention Program Research Group. Is there an effect of lifestyle or metformin therapy on coronary artery calcium (CAC) score? The investigators used the Diabetes Prevention Program (DPP) and its Outcome Study (DPPOS), a long-term intervention study in 3,234 subjects with prediabetes (mean [ standard deviation] age 64 10 years), which showed reduced diabetes risk with lifestyle and metformin compared with placebo over 3.2 years. DPPOS offered periodic group lifestyle sessions to all participants and continued metformin in the originally randomized metformin group. Subclinical atherosclerosis was assessed in 2,029 participants using CAC measurements after 14 years of average follow-up. CAC was expressed both as a continuous variable (CAC severity) and as a categorical variable, mainly using a cut point of 0 (CAC presence), but also using cut points of 10 and 100 Agatston units (AU). Mean age of participants at the time of scanning was 67 10 years in men and 63 9years in women, with mean study duration of 13.7 0.08 years since randomization. During DPPOS, 70% of nondiabetic metformin participants took metformin in any amount (mean 9.6 years) compared with 1% of nondiabetic participants in the lifestyle and 3% in the placebo groups (1.7 years in both groups). Statin use increased significantly over time in DPPOS to >50% of participants and not different acrosstreatment groups. After 14 years of follow-up, there were no CAC differences between lifestyle and placebo intervention groups, in either sex. CAC severity and presence were significantly lower among men in the metformin versus the placebo group (age-adjusted mean CAC severity: 39.5 vs. 6 Continue reading >>

University Of Glasgow - Research Institutes - Institute Of Cardiovascular & Medical Sciences - Research - Metabolic Disease & Diabetes Research - Cardiovascular Effects Of Metformin

University Of Glasgow - Research Institutes - Institute Of Cardiovascular & Medical Sciences - Research - Metabolic Disease & Diabetes Research - Cardiovascular Effects Of Metformin

Institute of Cardiovascular & Medical Sciences Metformin has been used to control blood sugar in type 2 diabetes for more than 50 years. Its protective properties on the heart have been recognised in recent years, including in our own work and collaborations. We are now conducting clinical trials to see whether metformins beneficial effects extend to other conditions. Metformin is widely regarded to have cardioprotective effects in type 2 diabetes which may be mediated via a number of mechanisms including activation of endothelial AMP kinase (see Vascular, Pathophysiology and Therapy Coordinated regulation of metabolism and vascular health ). Our recent studies indicate that metformin: (a) improves endothelial function in women with chest pain and normal coronary arteries [1]; (b) is associated with reduced mortality in chronic heart failure [2,3], (c) has an insulin-sparing effect in type 1 diabetes (T1DM) systematic review [4]. We are now conducting two double-blind randomised placebo-controlled trials (RCTs) examining the cardiovascular effects of metformin in two other conditions: The CAMERA trial (Principal Investigator: Prof N Sattar , ) is a single-centre randomised controlled trial (RCT) of metformin vs. placebo over 1.5 years in men and women with stable coronary artery disease (funded by the Chief Scientist Office of the Scottish Government). The primary endpoint is change in common carotid artery intima-media thickness (cIMT): results are due in late 2012. The REMOVAL trial (Chief Investigator: Prof JR Petrie , ) is an international multi-centre RCT of metformin vs. placebo over three years in men and women with type 1 diabetes (T1DM) aged 40 years and over. The primary endpoint is change in cIMT and secondary endpoints include changes in numerous important Continue reading >>

Metformin And Heart Failure

Metformin And Heart Failure

Innocent until proven guilty Throughout the world and for many years, metformin has been a mainstay of therapy for patients with type 2 diabetes. This highly effective and usually well-tolerated oral agent is, to date, the only one demonstrated to reduce cardiovascular disease (CVD) complications in newly diagnosed type 2 diabetic patients (1). It's precise mechanism of action remains enigmatic, although it clearly results in a reduction of endogenous glucose production, primarily hepatic gluconeogenesis, most likely involving the stimulation of AMP-activated protein kinase activity (2). A peripheral insulin-sensitizing effect in skeletal muscle has also been demonstrated by some, but not all, investigators (3). In small studies, metformin appears to exert benefit on various other fundamental biological processes that influence atherogenesis, such as lipid metabolism, inflammation, and vascular endothelial function (4). Another insulin sensitizer category, the thiazolidinediones (TZDs), has also been proposed to reduce CVD risk, but that class carries with it concerns of weight gain and fluid retention. As a result, TZDs remain more popular in combination therapy regimens. Perhaps of greatest import to clinicians is the recognition that metformin is the only oral antidiabetic agent associated with weight loss. Accordingly, metformin remains, in the eyes of many authorities, the optimal initial drug choice in most type 2 diabetic patients if diet and exercise have not succeeded in adequately reducing blood glucose levels (5). Approval of metformin in the U.S. was delayed because of previous experience with phenformin, which was associated with lactic acidosis. Although the risk of such metabolic decompensation with metformin was known to be significantly lower than with Continue reading >>

Effect Of Metformin Monotherapy On Cardiovascular Diseases And Mortality: A Retrospective Cohort Study On Chinese Type 2 Diabetes Mellitus Patients

Effect Of Metformin Monotherapy On Cardiovascular Diseases And Mortality: A Retrospective Cohort Study On Chinese Type 2 Diabetes Mellitus Patients

Effect of metformin monotherapy on cardiovascular diseases and mortality: a retrospective cohort study on Chinese type 2 diabetes mellitus patients Many factors influence whether the first-line oral anti-diabetic drug, metformin, should be initiated to a patient with type 2 diabetes mellitus (T2DM) early in the course of management in addition to lifestyle modifications. This study aims to evaluate the net effects of metformin monotherapy (MM) on the all-cause mortality and cardiovascular disease (CVD) events. A retrospective 5-year follow-up cohort study was conducted on Chinese adult patients with T2DM and without any CVD history under public primary care. Cox proportional hazard regressions were performed to compare the risk of all-cause mortality and CVD events (CHD, stroke, heart failure) between patients receiving lifestyle modifications plus MM (MM groups) and those with lifestyle modifications alone (control groups). 3400 pairs of matched patients were compared. MM group had an incidence rate of 7.5 deaths and 11.3 CVD events per 1000 person-years during a median follow-up period of 62.5months whereas control group had 11.1 deaths and 16.3 per 1000 person-years during a median follow-up period of 43.544.5months. MM group showed a 29.5 and 3035% risk reduction of all-cause mortality and CVD events (except heart failure) than control group (P<0.001). MM group was more prone to progress to chronic kidney disease but this was not statistically significant. Type 2 diabetic patients who were started on metformin monotherapy showed improvement in many of the clinical parameters and a reduction in all-cause mortality and CVD events than lifestyle modifications alone. If there is no contraindication and if tolerated, diabetic patients should be prescribed with metformin Continue reading >>

Diabetes Drug, Metformin, Lowers Risk Of Heart Disease Deaths Better Than Sulfonylureas, New Analysis Shows

Diabetes Drug, Metformin, Lowers Risk Of Heart Disease Deaths Better Than Sulfonylureas, New Analysis Shows

Study confirms metformin should be first-line therapy for treatment of #diabetes.- Click to Tweet #Diabetes drug metformin found more effective at lowering risk of heart disease deaths than sulfonylureas.- Click to Tweet Metformin outperforms other #diabetes drugs; doesn’t cause weight gain like other drugs, study confirms. - Click to Tweet A new analysis of 204 studies involving more than 1.4 million people suggests that metformin, the most frequently prescribed stand-alone drug for type 2 diabetes, reduces the relative risk of a patient dying from heart disease by about 30 to 40 percent compared to its closest competitor drug, sulfonylurea. The study, designed to assess the comparative — not absolute or individual — benefits and risks of more than a dozen FDA-approved drugs for lowering blood sugar in type 2 diabetes, is described in the April 19 issue of the Annals of Internal Medicine. Diabetes now affects almost 10 percent of the U.S. population and poses a growing public health threat, and most people will eventually need drug treatment, the researchers say. “Metformin looks like a clear winner,” says Nisa Maruthur, M.D., M.H.S., assistant professor of medicine at the Johns Hopkins University School of Medicine. “This is likely the biggest bit of evidence to guide treatment of type 2 diabetes for the next two to three years.” Maruthur, the lead author on the meta-analysis, notes that cardiovascular fatalities — heart attacks and strokes — are major risks for people with uncontrolled blood sugar, but it has never been clear if one diabetes drug is better than another at lowering these fatalities. Other diabetes-related complications include blindness, kidney failure and limb amputations. This review, Maruthur says, provides a much-needed update to Continue reading >>

Metformin Could Treat Cardiovascular Disease In People Without Type 2 Diabetes

Metformin Could Treat Cardiovascular Disease In People Without Type 2 Diabetes

Metformin could treat cardiovascular disease in people without type 2 diabetes Metformin could treat cardiovascular disease in people without type 2 diabetes Patients with chronic kidney disease could be at risk of type 2 diabetes 16 August 2016 The diabetes drug metformin has anti-inflammatory properties that could benefit people with non-diabetic cardiovascular disease (CVD), research suggests. Metformin is commonly used as a first-line treatment for type 2 diabetes , but previous studies have shown it can also improve survival in patients with pancreatic cancer , and prove useful in treating other conditions. To further examine the potential of metformin, Dundee University researchers studied its anti-inflammatory effects. They tested these effects on two different cohorts; one had type 2 diabetes, and the other had CVD but no diabetes. Patients either received metformin or sulphonylurea monotherapy - none of whom took either drug at the start of the trial. Co-lead author Dr Graham Rena explained that metformin acts differently to non-steroidal anti-inflammatory drugs by inhibiting a different target. These anti-inflammatory effects were observed in both cohorts. "This may accelerate investigation of drug utility in non-diabetic cardiovascular disease groups," according to the researchers, who now plan to conduct trials that identify "specific non-diabetic" patient groups who could benefit from metformin. Professor Jeremy Pearson of the British Heart Foundation added: "These findings offer further evidence that old drugs can perform new tricks. "Repurposed medicines can much more quickly benefit patients. If this existing and affordable drug can be repurposed as a heart disease treatment , then this is excellent news for the 2.3 million people in the UK living with Continue reading >>

Study Finds Few Beneficial Effects Of Metformin Drug For Cardiovascular Disease In People Without Diabetes

Study Finds Few Beneficial Effects Of Metformin Drug For Cardiovascular Disease In People Without Diabetes

Study finds few beneficial effects of metformin drug for cardiovascular disease in people without diabetes Despite high expectations for the commonly used diabetes drug metformin to improve risk factors for heart disease in people without diabetes, few beneficial effects have been found in a randomised trial of patients with established cardiovascular disease, published in The Lancet Diabetes & Endocrinology. "There has been a lot of anticipation based on research in diabetic patients suggesting that metformin has cardiovascular benefits beyond its effects on blood glucose. We were hoping to find that it might also prevent hardening of the arteries, a warning sign for future heart attacks and strokes, in people without diabetes already on a statin, explains study leader Dr David Preiss from the University of Glasgow in the UK. Metformin is a safe, inexpensive drug that is recommended as the first-line treatment for people with type 2 diabetes. It works by reducing the overactive glucose production associated with diabetes but it has also been shown to reduce other related risk factors for heart disease such as cholesterol levels, and inflammatory and blood clotting markers in earlier studies conducted before the common use of statins. The landmark UKPDS trial found that metformin treatment led to a 39% reduction in risk of heart attack over 10 years in diabetic patients, but whether its potential cardiovascular benefits could be replicated in individuals without diabetes had not been tested until now. The Carotid Atherosclerosis: MEtformin for insulin ResistAnce (CAMERA) trial, was designed to investigate the effect of metformin on changes in carotid intima-media thickness (cIMT; an established marker of atherosclerosis) in non-diabetic individuals with heart disease t Continue reading >>

Cardiovascular Safety Of Anti-diabetic Drugs

Cardiovascular Safety Of Anti-diabetic Drugs

Cardiovascular safety of anti-diabetic drugs Department of Pharmacology and Therapeutics Corresponding author: Tel: + 353 214905448, Email: [email protected] Search for other works by this author on: Department of Pharmacology and Therapeutics Department of Pharmacology and Therapeutics Center for Perinatal Medicine, Department of Obstetrics European Heart Journal - Cardiovascular Pharmacotherapy, Volume 2, Issue 1, 1 January 2016, Pages 3243, R. Kumar, D. M. Kerins, T. Walther; Cardiovascular safety of anti-diabetic drugs, European Heart Journal - Cardiovascular Pharmacotherapy, Volume 2, Issue 1, 1 January 2016, Pages 3243, Cardiovascular disease is the leading cause of morbidity and mortality among patients with diabetes, underscoring the importance of choosing anti-diabetic drugs that do not increase cardiovascular risk but might reduce the risk of cardiovascular events. Most type 2 diabetic patients die from cardiovascular causes despite the beneficial effects of blood pressure (BP) and lipid-lowering medications. The prevalence of patients with cardiovascular disease and diabetes mellitus is growing exponentially. Approximately 40% of patients hospitalized with heart failure and reduced ejection fraction have diabetes mellitus. The recent trials conducted in patients with heart failure who had diabetes showed a different response to standard medication, with these patients being more prone to develop side effects than patients with the same degree of heart failure but without diabetes mellitus. Therefore, careful selection of drug therapy paying particular attention to cardiovascular safety is important in optimizing diabetic therapy. This review discusses the efficacy and safety of the most commonly prescribed anti-diabetic drugs in the context of cardiovascul Continue reading >>

Common Diabetes Drugs Associated With Increased Risk Of Death

Common Diabetes Drugs Associated With Increased Risk Of Death

Follow all of ScienceDaily's latest research news and top science headlines ! Common diabetes drugs associated with increased risk of death Compared to another popular drug, three widely used diabetes medications are associated with a greater risk of death, a large new analysis finds. Compared to another popular drug, three widely used diabetes medications are associated with a greater risk of death, a large new analysis finds. The results were presented June 25 at The Endocrine Society's 94th Annual Meeting in Houston. The drugs, glipizide, glyburide, and glimepiride, are known as sulfonylureas, which help decrease blood-sugar levels among type 2 diabetes patients by stimulating the pancreas to produce insulin. In the past, these medications were considered comparable to one another in terms of effectiveness and safety. Recently, however, research has shown some sulfonylureas may be safer than others. These findings led to this latest research, which compared them to another type of blood-sugar-reducing drug known as metformin. All four medications are available under low-cost, generic labels. "We have clearly demonstrated that metformin is associated with a substantial reduction in mortality risk, and, thus, should be the preferred first-line agent, if one has a choice between metformin and a sulfonylurea," said study lead author Kevin M. Pantalone, D.O., an endocrinologist at Summa Western Reserve Hospital in Cuyahoga Falls, OH, who conducted this study in conjunction with a team of researchers from Cleveland Clinic in Cleveland, OH. In the United States, nearly 26 million people, or 8 percent of the population, have diabetes, according to the Centers for Disease Control and Prevention. Many of these patients also have other underlying medical conditions, including Continue reading >>

Impact Of Metformin On Cardiovascular Disease: A Meta-analysis Of Randomised Trials Among People With Type 2 Diabetes

Impact Of Metformin On Cardiovascular Disease: A Meta-analysis Of Randomised Trials Among People With Type 2 Diabetes

Impact of metformin on cardiovascular disease: a meta-analysis of randomised trials among people with type 2 diabetes 1,2 James K. Leaver ,1 and Greg J. Irving 1 1The Primary Care Unit, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Box 113 Cambridge Biomedical Campus, Cambridge, CB2 0SR UK 2MRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK 1The Primary Care Unit, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Box 113 Cambridge Biomedical Campus, Cambridge, CB2 0SR UK 1The Primary Care Unit, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Box 113 Cambridge Biomedical Campus, Cambridge, CB2 0SR UK 1The Primary Care Unit, Institute of Public Health, School of Clinical Medicine, University of Cambridge, Box 113 Cambridge Biomedical Campus, Cambridge, CB2 0SR UK 2MRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK Simon J. Griffin, Email: [email protected] . Received 2017 Apr 21; Accepted 2017 May 24. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. This article has been cited by other articles in PMC. Metformin is the most-prescribed oral medication to lower blood glucose worldwide. Yet previous systematic reviews have raised doubts about its effectiveness in r Continue reading >>

Metformin And Vascular Protection: A Cardiologist's View - Em|consulte

Metformin And Vascular Protection: A Cardiologist's View - Em|consulte

Metformin and vascular protection: a cardiologist's view [1]Leducq Center for Cardiovascular Research, Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital,Harvard Medical School, Boston, USA. [2]MD, Leducq Center for Cardiovascular Research, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave. EBRC 307, Boston. MA 02115, USA. Phone: +1 617 278 0087 Fax: +1 617 732 6961 E-mail: The predicted global epidemic of type 2 diabetes highlights the importance of identifying the most effective ways to reduce the risk of long-term diabetic complications. Although hyperglycaemia is undoubtedly a risk factor for microvascular complications, intensive glycaemic management has delivered only modest improvements in macrovascular endpoints thus far. A multidisciplinary approach addressing the components of the dysmetabolic syndrome, including insulin resistance, dyslipidaemia, hypertension, obesity and impaired fibrinolysis, will be required to protect the cardiovascular system more effectively. The potential vascular protective effects of metformin, demonstrated by the UK Prospective Diabetes Study, may complement other strategies within such a framework. Keywords: Metformin , Type 2 diabetes , Cardiovascular disease , Metabolic syndrome Decades of intensive research into the pathophysiology and management of type 2 diabetes leave us with a better understanding of its aetiology and prognosis than ever before. Nevertheless, we still have much to learn, as our current projections of the future burden of type 2 diabetes (summarised elsewhere in this supplement) make grim reading. Indeed, the prevalence of type 2 diabetes is increasing in virtually all populations and appears with escalating frequency in children and adolescents. We Continue reading >>

Metformin For Non-diabetic Patients With Coronary Heart Disease (the Camera Study): A Randomised Controlled Trial - Sciencedirect

Metformin For Non-diabetic Patients With Coronary Heart Disease (the Camera Study): A Randomised Controlled Trial - Sciencedirect

Metformin for non-diabetic patients with coronary heart disease (the CAMERA study): a randomised controlled trial Author links open overlay panel DrDavidPreissPhDa Open Access funded by Chief Scientist Office Metformin reduces cardiovascular risk in patients with type 2 diabetes seemingly independent of lowering blood glucose concentration. We assessed the cardiovascular effects of metformin in individuals without type 2 diabetes. We did a single-centre, double-blind, placebo-controlled trial at the Glasgow Clinical Research Facility (Glasgow, UK). We enrolled patients taking statins who did not have type 2 diabetes but who did have coronary heart disease and large waist circumferences. Participants were randomly assigned (1:1) by computer to either metformin (850 mg twice daily) or matching placebo in block sizes of four. Patients, investigators, trial staff, and statisticians were masked to treatment allocation. The primary endpoint was progression of mean distal carotid intima-media thickness (cIMT) over 18 months in the modified intention-to-treat population. Secondary endpoints were changes in carotid plaque score (in six regions), measures of glycaemia (HbA1c, fasting glucose, and insulin concentrations, and Homeostasis Model Assessment of Insulin Resistance [HOMA-IR]), and concentrations of lipids, high sensitivity C-reactive protein, and tissue plasminogen activator. The trial was registered at ClinicalTrials.gov , number NCT00723307 . We screened 356 patients, of whom we enrolled 173 (86 in the metformin group, 87 in the placebo group). Average age was 63 years. At baseline, mean cIMT was 0717 mm (SD 0129) and mean carotid plaque score was 243 (SD 155). cIMT progression did not differ significantly between groups (slope difference 0007 mm per year, 95% CI 0006 Continue reading >>

More in diabetes