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Patient-factors associated with metformin steady-state levels in type 2 diabetes mellitus with therapeutic dosage.

ABSTRACT: This prospective study aimed to analyze metformin steady-state concentration in repeated constant dosage and the influencing patient-factors as well as to correlate them with glycemic control.The validated HPLC-UV method was used to examine metformin steady-state concentration, while FBG and glycated albumin were used as the parameters of glycemic control during metformin administration.A total of 82 type-2 diabetes patients were involved with 32.1% of them having metformin Cssmin and 84.1% having Cssmax of metformin within the recommended therapeutic range. One patient had metformin Css that exceeded minimum toxic concentration despite his normal renal function and administered therapeutic dosage of metformin. Higher Cssmax was found in patients with metformin monotherapy, while patients with longer duration of metformin use had significantly higher Cssmin.Along with initial hyperglycemia and eGFR, metformin Cssmin became the only parameter that influenced FBG level (P?

SUBMITTER: Ningrum VDA

PROVIDER: S-EPMC5992324 | biostudies-other | 2018 Jun

REPOSITORIES: biostudies-other

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Patient-factors associated with metformin steady-state levels in type 2 diabetes mellitus with therapeutic dosage.

Ningrum Vitarani D A VDA Ikawati Zullies Z Sadewa Ahmad H AH Ikhsan Mohammad R MR

Journal of clinical & translational endocrinology 20180513

<h4>Aims</h4>This prospective study aimed to analyze metformin steady-state concentration in repeated constant dosage and the influencing patient-factors as well as to correlate them with glycemic control.<h4>Methods</h4>The validated HPLC-UV method was used to examine metformin steady-state concentration, while FBG and glycated albumin were used as the parameters of glycemic control during metformin administration.<h4>Results</h4>A total of 82 type-2 diabetes patients were involved with 32.1% o ...[more]

PMID: 29892566

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Project description:BackgroundSmall cross-sectional studies have suggested that metformin, a first-line oral hypoglycemic agent, may lower thyroid-stimulating hormone (TSH) levels. Our objective was to determine whether the use of metformin monotherapy, when compared with sulfonylurea monotherapy, is associated with an increased risk of low TSH levels (<0.4 mIU/L) in patients with type 2 diabetes mellitus.MethodsUsing the Clinical Practice Research Datalink, we identified patients who began receiving metformin or sulfonylurea monotherapy between Jan. 1, 1988, and Dec. 31, 2012. We assembled 2 subcohorts of patients with treated hypothyroidism or euthyroidism, and followed them until Mar. 31, 2013. We used Cox proportional hazards models to evaluate the association of low TSH levels with metformin monotherapy, compared with sulfonylurea monotherapy, in each subcohort.ResultsA total of 5689 patients with treated hypothyroidism and 59,937 euthyroid patients were included in the subcohorts. Among patients with treated hypothyroidism, 495 events of low TSH levels were observed during follow-up (incidence rate 119.7/1000 person-years). In the euthyroid group, 322 events of low TSH levels were observed (incidence rate 4.5/1000 person-years). Compared with sulfonylurea monotherapy, metformin monotherapy was associated with a 55% increased risk of low TSH levels in patients with treated hypothyroidism (incidence rate 79.5/1000 person-years v. 125.2/1000 person-years, adjusted hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.09-2.20), with the highest risk in the 90-180 days after initiation (adjusted HR 2.30, 95% CI 1.00-5.29). No association was observed in euthyroid patients (adjusted HR 0.97, 95% CI 0.69-1.36).InterpretationIn this longitudinal population-based study, metformin use was associated with an increased incidence of low TSH levels in patients with treated hypothyroidism, but not in euthyroid patients. The clinical consequences of this need further investigation.

Dataset Information

Patient-factors associated with metformin steady-state levels in type 2 diabetes mellitus with therapeutic dosage.

Publications

Patient-factors associated with metformin steady-state levels in type 2 diabetes mellitus with therapeutic dosage.

Similar Datasets

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