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Therapies
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 31 mars 2018
Doi : 10.1016/j.therap.2018.01.006
Received : 3 October 2017 ;  accepted : 23 January 2018
Efficacy of metformin on glycemic control and weight in drug-naive type 2 diabetes mellitus patients: A systematic review and meta-analysis of placebo-controlled randomized trials
 

Carole Piera-Mardemootoo a, Philippe Lambert a, Jean-Luc Faillie b, c,
a Department of general medicine, Faculty of medicine, University of Montpellier, 34295 Montpellier, France 
b Department of medical pharmacology and toxicology, CHU Montpellier, 34295 Montpellier, France 
c Laboratory of biostatistics, epidemiology and public health (EA 2415), Faculty of medicine, University of Montpellier, 34295 Montpellier, France 

Corresponding author. Département de pharmacologie médicale et toxicologie, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France.
Summary
Aim of the study

Metformin is recommended as the first-line treatment of type 2 diabetes mellitus. Despite its common use, few studies have been conducted to precisely measure the efficacy of metformin versus placebo as a first-line treatment. This study aims to assess the precise effects of metformin monotherapy on glycemic control and weight in drug-naive patients with type 2 diabetes mellitus.

Methods

Medline® and Cochrane databases were searched until March 19, 2016 to perform a systematic review and meta-analysis of placebo-controlled randomized trials evaluating metformin monotherapy in drug-naive patients with type 2 diabetes mellitus. Assessed outcomes include glycemic control (fasting plasma glucose, glycosated hemoglobin) and weight.

Results

Overall, 16 studies (1140 patients) were selected. Compared to placebo, metformin monotherapy was associated with decreased glycosated hemoglobin by 0.95% at 3 months (95% CI: 0.50 to 1.39, I 2=87%) and 1.32% at 6 months (95% CI: 1.01 to 1.62, I 2=71%), and decreased fasting plasma glucose by 1.92mmol/L at 1 month (95% CI: 0.11 to 3.74, I 2=88%), 1.79mmol/L at 3 months (95% CI: 0.92 to 2.66, I 2=88%) and 2.14mmol/L at 6 months (95% CI: 1.17 to 3.12, I 2=82%). No significant difference was demonstrated for the comparisons of weight due to relatively small number of studies retrieved from the literature resulting in insufficient statistical power.

Conclusion

This study provides the precise effects of metformin monotherapy regarding the decreases in fasting plasma glucose and glycosated hemoglobin that physician can expected in drug-naive patients with type 2 diabetes mellitus. No evidence was found for the effects on weight.

The full text of this article is available in PDF format.

Keywords : Type 2 diabetes mellitus, Metformin, Meta-analysis, Randomized controlled trials




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