A comparative study to evaluate the efficacy of metformin monotherapy on glycemic markers in normal weight, over weight, and obese patients with Type 2 diabetes mellitus

ABSTRACT

Background: Metformin has been recommended as pharmacological therapy of first choice in Type 2 diabetes mellitus (T2DM) but there remains a gap in the present literature regarding relative efficacy and choice of metformin as monotherapy in patients who are non-obese when compared to obese. Aim and Objectives: The aim of the study was to evaluate the efficacy of Metformin as monotherapy on glycemic markers in normal weight, over weight, and obese T2DM patients. Materials and Methods: After obtaining permission from institutional ethics committee, 90 treatment naïve patients with T2DM who met inclusion criteria were included in this study. They were categorized into normal weight, over weight, and obese based on BMI. Efficacy was measured by reduction in glycemic parameters at end of weeks 4, 8, 12, and 16 from baseline. Safety was assessed by monitoring adverse events. Data analyzed using analysis of variance, Student t-test for continuous data and Chi-square test for categorical data. Results: There was a significant decrease in glycosylated hemoglobin, fasting blood sugar, and postprandial blood sugar levels from baseline to end of 16 weeks in all three groups (P < 0.001) but the difference was not statistically significant between the three groups (P > 0.05). A significant decrease in body weight was observed in overweight and obese group whereas the reduction (0.3 Kg) is not significant in normal weight group. The treatment was well tolerated in all three groups. Conclusion: Metformin in normal weight group was found to be as efficacious as that of overweight and obese group for treating newly detected T2DM. Furthermore, the weight loss in normal weight group is negligible compared to overweight and obese group patients.