Impact of the timing of metformin administration on glycaemic and glucagon-like peptide-1 responses to intraduodenal glucose infusion in type 2 diabetes: a double-blind, randomised, placebo-controlled, crossover study
Authors' conclusion
In well-controlled metformin-treated type 2 diabetes, glucose-lowering by metformin is greater when it is given before, rather than with, enteral glucose, and this is associated with a greater GLP-1 response. These observations suggest that administration of metformin before meals may optimise its effect in improving postprandial glycaemic control.
Study context
- Population
- Individuals with T2D relatively well-controlled by metformin monotherapy; intraduodenal glucose infusion 12.56 kJ/min (3 kcal/min) at t = 0–60 mincrossover, 4 study days
- Participants
- 16 individuals
- Comparison
- Intraduodenal metformin at t = −60, −30 or 0 min vs saline (control) before intraduodenal glucose infusion
Methodological detailsdouble-blind, placebo-controlled, crossover
- Double-blind
- Placebo-controlled
- Crossover
Primary result
As reported in the abstract
Plasma glucose, GLP-1 and insulin responses · t = -60 to 120 min
- Treatment-by-time interaction for metformin in reducing plasma glucose and increasing plasma GLP-1 and insulin
- p<0.05 for each
- Greater reduction in plasma glucose with metformin at t = −60 or −30 min vs t = 0 min
- p<0.05 for each
- Increases in plasma GLP-1 evident only with metformin at t = −60 or −30 min
- p<0.05 for each
Further findings
- Metformin enhanced glucose-induced insulin secretion
- P < 0.05
- Metformin did not influence insulin sensitivity
- Increases in plasma insulin comparable on the 3 metformin days
Original publication
Impact of the timing of metformin administration on glycaemic and glucagon-like peptide-1 responses to intraduodenal glucose infusion in type 2 diabetes: a double-blind, randomised, placebo-controlled, crossover study. Diabetologia. Published 1 April 2024. doi:10.
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