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2. Long-term treatment with metformin in type 2 diabetes and methylmalonic acid: Post hoc analysis of a randomized controlled 4.3year trial.

Author

UCL - SSH/LouRIM - Louvain Research Institute in Management and Organizations, Out, Mattijs, Kooy, Adriaan, Lehert, Philippe, Schalkwijk, Casper A, Stehouwer, Coen D A, UCL - SSH/LouRIM - Louvain Research Institute in Management and Organizations, Out, Mattijs, Kooy, Adriaan, Lehert, Philippe, Schalkwijk, Casper A, and Stehouwer, Coen D A

Abstract

AIMS: Metformin treatment is associated with a decrease of serum vitamin B12, but whether this reflects tissue B12 deficiency is controversial. We studied the effects of metformin on serum levels of methylmalonic acid (MMA), a biomarker for tissue B12 deficiency, and on onset or progression of neuropathy. METHODS: In the HOME trial, 390 insulin-treated patients with type 2 diabetes were treated with metformin or placebo for 52months. In a post hoc analysis, we analyzed the association between metformin, MMA and a validated Neuropathy Score (NPS). RESULTS: Metformin vs placebo increased MMA at the end of the study (95%CI: 0.019 to 0.055, p=0.001). Mediation analysis showed that the effect of metformin on the NPS consisted of a beneficial effect through lowering HbA1c (-0.020 per gram year) and an adverse effect through increasing MMA (0.042 per gram year), resulting in a non-significant net effect (0.032 per gram year, 95% CI: -0.121 to 0.182, p=0.34). CONCLUSION: Metformin not only reduces serum levels of B12, but also progressively increases serum MMA. The increase of MMA in metformin users was associated with significant worsening of the NPS. These results provide further support that metformin-related B12 deficiency is clinically relevant. Monitoring of B12 in users of metformin should be considered. TRIAL REGISTRATION: ClinicalTrials.gov NCT00375388.

Published
2018

5. Metformin Treatment Is Associated With Increased Serum Levels of Methylmalonic Acid in Patients With Type 2 Diabetes Treated With Insulin: A Placebo-Controlled 4-Year Trial

Author

UCL - SSH/ILSM - Louvain School of Management Research Institute, Out, Mattijs, Kooy, Adriaan, Lehert, Philippe, 73th congress of American Diabetes Association (ADA), UCL - SSH/ILSM - Louvain School of Management Research Institute, Out, Mattijs, Kooy, Adriaan, Lehert, Philippe, and 73th congress of American Diabetes Association (ADA)

Published
2013

6. SNPs Related to the Glucose Lowering Effect of Metformin: Do they Affect Plasma Concentrations of Metformin (MPC) and their Effects on Insulin Requirements (DDI)

Author

UCL - SSH/ILSM - Louvain School of Management Research Institute, Out, Mattijs, Kooy, Adriaan, Becker, Mattijs L., Lehert, Philippe, 73th congress of American Diabetes Association (ADA), UCL - SSH/ILSM - Louvain School of Management Research Institute, Out, Mattijs, Kooy, Adriaan, Becker, Mattijs L., Lehert, Philippe, and 73th congress of American Diabetes Association (ADA)

Published
2013

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