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Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study

Bray, George A.; Edelstein, Sharon L.; Crandall, Jill P.; Aroda, Vanita R.; Franks, Paul LU ; Fujimoto, Wilfred; Horton, Edward; Jeffries, Susan; Montez, Maria and Mudaliar, Sunder, et al. (2012) In Diabetes Care 35(4). p.731-737
Abstract
OBJECTIVE-Metformin produced weight loss and delayed or prevented diabetes in the Diabetes Prevention Program (DPP). We examined its long-term safety and tolerability along with weight loss, and change in waist circumference during the DPP and its long-term follow-up. RESEARCH DESIGN AND METHODS-The randomized double-blind clinical trial of metformin or placebo followed by a 7-8-year open-label extension and analysis of adverse events, tolerability, and the effect of adherence on change in weight and waist circumference. RESULTS-No significant safety issues were identified. Gastrointestinal symptoms were more common in metformin than placebo participants and declined over time. During the DPP, average hemoglobin and hematocrit levels were... (More)
OBJECTIVE-Metformin produced weight loss and delayed or prevented diabetes in the Diabetes Prevention Program (DPP). We examined its long-term safety and tolerability along with weight loss, and change in waist circumference during the DPP and its long-term follow-up. RESEARCH DESIGN AND METHODS-The randomized double-blind clinical trial of metformin or placebo followed by a 7-8-year open-label extension and analysis of adverse events, tolerability, and the effect of adherence on change in weight and waist circumference. RESULTS-No significant safety issues were identified. Gastrointestinal symptoms were more common in metformin than placebo participants and declined over time. During the DPP, average hemoglobin and hematocrit levels were slightly lower in the metformin group than in the placebo group. Decreases in hemoglobin and hematocrit in the metformin group occurred during the first year following randomization, with no further changes observed over time. During the DPP, metformin participants had reduced body weight and waist circumference compared with placebo (weight by 2.06 +/- 5.65% vs. 0.02 +/- 5.52%, P < 0.001, and waist circumference by 2.13 +/- 7.06 cm vs. 0.79 +/- 6.54 cm, P < 0.001 in metformin vs. placebo, respectively). The magnitude of weight loss during the 2-year double-blind period was directly related to adherence (P < 0.001). Throughout the unblinded follow-up, weight loss remained significantly greater in the metformin group than in the placebo group (2.0 vs. 0.2%, P < 0.001), and this was related to the degree of continuing metformin adherence (P < 0.001). CONCLUSIONS-Metformin used for diabetes prevention is safe and well tolerated. Weight loss is related to adherence to metformin and is durable for at least 10 years of treatment. (Less)
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Contribution to journal
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published
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in
Diabetes Care
volume
35
issue
4
pages
731 - 737
publisher
American Diabetes Association
external identifiers
  • wos:000301959600013
  • scopus:84859372038
ISSN
1935-5548
DOI
10.2337/dc11-1299
language
English
LU publication?
yes
id
7650437d-c255-4d84-8bd6-acc296335808 (old id 2587608)
date added to LUP
2012-06-01 09:37:37
date last changed
2017-11-05 03:53:00
@article{7650437d-c255-4d84-8bd6-acc296335808,
  abstract     = {OBJECTIVE-Metformin produced weight loss and delayed or prevented diabetes in the Diabetes Prevention Program (DPP). We examined its long-term safety and tolerability along with weight loss, and change in waist circumference during the DPP and its long-term follow-up. RESEARCH DESIGN AND METHODS-The randomized double-blind clinical trial of metformin or placebo followed by a 7-8-year open-label extension and analysis of adverse events, tolerability, and the effect of adherence on change in weight and waist circumference. RESULTS-No significant safety issues were identified. Gastrointestinal symptoms were more common in metformin than placebo participants and declined over time. During the DPP, average hemoglobin and hematocrit levels were slightly lower in the metformin group than in the placebo group. Decreases in hemoglobin and hematocrit in the metformin group occurred during the first year following randomization, with no further changes observed over time. During the DPP, metformin participants had reduced body weight and waist circumference compared with placebo (weight by 2.06 +/- 5.65% vs. 0.02 +/- 5.52%, P &lt; 0.001, and waist circumference by 2.13 +/- 7.06 cm vs. 0.79 +/- 6.54 cm, P &lt; 0.001 in metformin vs. placebo, respectively). The magnitude of weight loss during the 2-year double-blind period was directly related to adherence (P &lt; 0.001). Throughout the unblinded follow-up, weight loss remained significantly greater in the metformin group than in the placebo group (2.0 vs. 0.2%, P &lt; 0.001), and this was related to the degree of continuing metformin adherence (P &lt; 0.001). CONCLUSIONS-Metformin used for diabetes prevention is safe and well tolerated. Weight loss is related to adherence to metformin and is durable for at least 10 years of treatment.},
  author       = {Bray, George A. and Edelstein, Sharon L. and Crandall, Jill P. and Aroda, Vanita R. and Franks, Paul and Fujimoto, Wilfred and Horton, Edward and Jeffries, Susan and Montez, Maria and Mudaliar, Sunder and Pi-Sunyer, F. Xavier and White, Neil H. and Knowler, William C.},
  issn         = {1935-5548},
  language     = {eng},
  number       = {4},
  pages        = {731--737},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study},
  url          = {http://dx.doi.org/10.2337/dc11-1299},
  volume       = {35},
  year         = {2012},
}