Metformin May Preserve Beta-Cell Function in T2DM

HealthDay News — After induction of short-term intensive insulin therapy (IIT), metformin is superior to intermittent IIT for maintaining beta-cell function and glycemic control during the course of 2 years, according to a study published in Diabetes, Obesity and Metabolism.

Ravi Retnakaran, MD, from the University of Toronto, and colleagues randomly assigned 24 adults with type 2 diabetes mellitus (T2DM) of 2 years’ duration and HbA_1c of 6.4 to 3 weeks of induction IIT (glargine, lispro) followed by either repeat IIT for up to 2 weeks every 3 months or daily metformin.

The researchers found that baseline-adjusted Insulin Secretion-Sensitivity Index-2 at 2 years was higher in the metformin arm compared to intermittent IIT (245±31.7 vs 142.2±18.4). Baseline-adjusted HbA_1c at 2 years was lower in the metformin arm (6%±0.2% vs 7.3%±0.2%). Two-thirds of participants (66.7%) randomly assigned to metformin had HbA_1c ≤6% at study completion vs 8.3% of those on intermittent IIT. No differences in insulin sensitivity were seen.

“The strategy of induction and maintenance therapy to preserve beta-cell function warrants exploration in early T2DM,” the authors wrote.

Disclosures: One author disclosed financial ties to the pharmaceutical industry.

Reference

Retnakaran R, Choi H, Ye C, Kramer CK, Zinman B. A 2-year trial of intermittent insulin therapy versus metformin for the preservation of beta-cell function after initial short-term intensive insulin induction in early type 2 diabetes [published online January 27, 2018].  Diabetes Obes Metab. doi:10.1111/dom.13236