caa a22 4500 465745644 CHVBK 20180323111819.0 cr unu---uuuuu 170327e19900401xx s 000 0 eng 10.1007/BF02581286 doi (NATIONALLICENCE)springer-10.1007/BF02581286 Low dose metformin in the treatment of type II non-insulin-dependent diabetes: Clinical and metabolic evaluations [Elektronische Daten] [Franco Gregorio, Franca Ambrosi, Piero Marchetti, Sonia Cristallini, Renzo Navalesi, Paolo Brunetti, Paolo Filipponi] Summary: Low doses of metformin (500 mg twice daily) were administered to 20 diabetic patients, combined with the original sulfonylurea treatment which had become ineffective even at full dosage. After 1 and 5 weeks, the effects of the drug on glycemic control, blood intermediate metabolites and monocyte insulin receptors were monitored. Metformin clearly improved glycemic control by reducing both fasting blood glucose from 189.88±21.11 mg/dl to 131.12±16.02 mg/dl after 1 week and to 130.11±13.29 mg/dl after 5 weeks (p<0.025 both after 1 and 5 weeks); the diurnal blood glucose average fell from 235.33±24.11 mg/dl to 174.66±23.45 mg/dl (p<0.0025) after 1 week and to 177.65±21.71 mg/dl (p<0.0005) after 5 weeks. Consequently both blood glycosylated hemoglobin (p=n.s. after 1 week, p<0.025 after 5 weeks) and serum fructosamine (p<0.0025 after both 1 and 5 weeks) also decreased after metformin treatment. No change in plasma insulin and C-peptide levels was reported and no modification in diurnal rhythms of blood lactate, pyruvate, alanine glycerol and β-OH-butyrate was detected at any time during metformin treatment. All the changes documented in the binding values were already complete at the end of the first week: insulin binding to monocytes increased slightly but significantly (p<0.05) and the number of receptors per cell rose (p<0.05) but could not be correlated to any index of glycemic control. These data suggest that the antidiabetic action of metformin is neither related to its lactate-increasing activity nor does it depend upon its inducing an increase in insulin binding values. This metformin-related hypoglycemic effect might be the result, at least in part, of a reduced oxidative phosphorylation without inhibition of hepatic guconeogenesis and/or of decreased hepatic glucose output. Moreover, our data are also consistent with the hypothesis that metformin might affect insulin action at a post-receptor level. Casa Editrica «il Ponte», 1990 Glycemic control nationallicence Insulin receptors nationallicence Intermediate metabolites nationallicence Metformin nationallicence Gregorio Franco Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut Ambrosi Franca Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut Marchetti Piero Cattedra di Malattie del Ricambio, Istituto di Clinica Medica II, Università di Pisa, Pisa aut Cristallini Sonia Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut Navalesi Renzo Cattedra di Malattie del Ricambio, Istituto di Clinica Medica II, Università di Pisa, Pisa aut Brunetti Paolo Istituto di Patologia Speciale Medica, Università di Perugia, Perugia, Italy aut Filipponi Paolo Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut Acta diabetologia latina Springer-Verlag 27/2(1990-04-01), 139-155 0001-5563 27:2<139 1990 27 592 https://doi.org/10.1007/BF02581286 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02581286 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gregorio Franco Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut NATIONALLICENCE 700 1- Ambrosi Franca Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut NATIONALLICENCE 700 1- Marchetti Piero Cattedra di Malattie del Ricambio, Istituto di Clinica Medica II, Università di Pisa, Pisa aut NATIONALLICENCE 700 1- Cristallini Sonia Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut NATIONALLICENCE 700 1- Navalesi Renzo Cattedra di Malattie del Ricambio, Istituto di Clinica Medica II, Università di Pisa, Pisa aut NATIONALLICENCE 700 1- Brunetti Paolo Istituto di Patologia Speciale Medica, Università di Perugia, Perugia, Italy aut NATIONALLICENCE 700 1- Filipponi Paolo Cattedra di Malattie del Ricambio Istituto di Clinica Medica Generale, Università di Perugia Politecnico Monteluce, 06100, Perugia, Italy aut NATIONALLICENCE 773 0- Acta diabetologia latina Springer-Verlag 27/2(1990-04-01), 139-155 0001-5563 27:2<139 1990 27 592 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer