European Journal of Clinical Pharmacology

, Volume 44, Issue 2, pp 107–112 | Cite as

Metformin for obese, insulin-treated diabetic patients: improvement in glycaemic control and reduction of metabolic risk factors

  • D. Giugliano
  • A. Quatraro
  • G. Consoli
  • A. Minei
  • A. Ceriello
  • N. De Rosa
  • F. D'Onofrio


The efficacy and safety of metformin in the treatment of obese, non-insulin-dependent, diabetic subjects poorly controlled by insulin after secondary failure to respond to sulphonylureas has been investigated. Fifty insulin-treated, obese diabetics participated in this prospective, randomised double-blind six-month trial. After a four-week run-in period, during which all patients were given placebo (single-blind), patients were randomly assigned to continue to receive placebo or to active treatment with metformin.

At six months, there was a relevant and significant improvement in glycaemic control in diabetics receiving the combined insulin-metformin treatment (decrease in glucose −4.1 mmol·l−1; glycosylated haemoglobin A1 decrease −1.84%). No significant changes were seen in diabetics receiving insulin and placebo. There was a significant decrease in blood lipids (trygliceride and cholesterol), an increase in HDL-cholesterol and a reduction in blood pressure in diabetics taking metformin. These postive findings were most marked in the 14 diabetics who experienced a good response to metformin (glucose profile <10 mmol·l−1), and were less marked but still significant in the remaining 13 diabetics, whose response to therapy was not so good (glucose profile >10 mmol·l−1). The fasting insulin level was significantly lower after six months of combined insulin-metformin treatment as shown by a 25% reduction in the daily dose of insulin (−21.6 U/day).

Metformin was well tolerated by all diabetics. Combining metforming with insulin in obese, insulin-treated and poorly controlled diabetics may represent a safe strategy to achieve better glycaemic control with a reduction in certain metabolic risk factors associated with the increased incidence of cardiovascular disease in diabetes mellitus.

Key words

Metformin Diabetes mellitus noninsulin-dependent secondary failure to sulphonylureas combined therapy glucose homoeostasis plasma lipids blood pressure adverse effects 


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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • D. Giugliano
    • 1
  • A. Quatraro
    • 2
  • G. Consoli
    • 2
  • A. Minei
    • 2
  • A. Ceriello
    • 3
  • N. De Rosa
    • 1
  • F. D'Onofrio
    • 1
  1. 1.Department of Geriatrics and Metabolic Diseases, First Faculty of MedicineUniversity of NaplesItaly
  2. 2.Diabetic Clinic S. RitaTarantoItaly
  3. 3.Institute of Internal MedicineUniversity of UdineItaly

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