“Low Dose” Metformin Improves Hyperglycemia Better than Acarbose in Type 2 Diabetics

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The Review of Diabetic Studies,2004,1,2,89-94.
Published:August 2004
Type:Original Article
Author(s) affiliations:

Ken Yajima1,3, Akira Shimada1, Hiroshi Hirose1, Akira Kasuga2, Takao Saruta1

1Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

2Department of Internal Medicine, Tokyo Denryoku Hospital, Tokyo, 160-0016, Japan.

3Department of Internal Medicine, Hamamatsu Red Cross Hospital, Hamamatsu, 430-0907, Japan.


Objectives: “High dose” metformin therapy (2,550 mg/day) is reported to improve glycemic control in type 2 diabetic patients with obesity (body mass index (BMI) ≥ 30). Some have reported that metformin therapy, even in low doses (500-750 mg/day), improves glycemic control in nonobese type 2 diabetic patients (BMI approximately 25). However, it is unclear whether “low dose” metformin improves glycemic control better than acarbose in non-obese type 2 diabetic patients, which has been shown to improve glycemic control in type 2 diabetes with obesity. Methods: We randomly divided 22 non-obese type 2 diabetic patients (mean BMI approximately 25) into two groups (A = 11, B = 11). Group A was treated with “low dose” metformin (500-750 mg/day) for 3 months, and switched to acarbose (150-300 mg/day) for another 3 months. Group B was treated with acarbose first, and then switched to “low dose” metformin. Results: “Low dose” metformin significantly decreased the fasting plasma glucose (FPG) and HbA1c level in both groups A and B, whereas acarbose decreased HbA1c levels in group B but not in group A. Overall, “low dose” metformin significantly decreased HbA1c (p = 0.0165) levels as compared to acarbose. Conclusion: In conclusion, “low dose” metformin therapy improved glycemic control better than acarbose in nonobese diabetics.