Jan Mohammad Shaikh, Riaz Ahmed Shaikh, Ahmed Danyal, Muhammad Yousuf Salat, Mehar Ali.
Effect of Metformin therapy on serum insulin, lipid and lipoprotein levels in patients with type 2 Diabetes Mellitus.
Med Channel Jan ;14(1):18-21.

OBJECTIVE: Abnormalities of lipid metabolism are common among patients with type 2 diabetes mellitus; these abnormalities increase the risk of morbidity and mortality from ischemic heart diseases. Insulin resistance is an important cause of abnormal carbohydrate and lipid metabolism. Metformin improves glycemic control in patients with type 2 diabetes mellitus without affecting serum insulin levels. It may produce its effect by decreasing insulin resistance. This study was conducted to observe effects of metformin on lipid profile in patients with type 2 diabetes mellitus; as drug decreases insulin resistance, which is an important cause of lipid abnormalities. SETTING: Fourteen patients with type 2 diabetes mellitus taking oral antidiabetic agents were selected. Antidiabetic drugs were stopped for one week and metformin was started with a dose of 500 mg/day, dose of the drug was titrated according to glycemic control. All participants received metformin for three weeks. Blood glucose, serum insulin, cholesterol, triglycerides, HDL, LDL and VLDL cholesterol were determined before and after metformin therapy. RESULTS: After three week therapy with metformin serum total cholesterol and LDL cholesterol reduced (P < 0.004 and < 0.001 respectively), HDL cholesterol elevated significantly (P < 0.002) and blood glucose reduced significantly (P < 0.005). However, no significant changes in serum insulin, triglyceride and VLDL cholesterol were observed. CONCLUSION: Elevation in LDL cholesterol and reduction in HDL cholesterol levels are commonly associated with atheromatous lipid profile. The results of this work indicate that metformin therapy change these parameters favorably.

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