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Does metformin decrease blood pressure in patients with Type 2 diabetes intensively treated with insulin?

M G Wulffelé1, A Kooy, P Lehert

  • 1Department of Internal Medicine, Bethesda General Hospital, Hoogeveen, The Netherlands.

Diabetic Medicine : a Journal of the British Diabetic Association
|June 25, 2005
PubMed
Summary
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Metformin did not significantly lower blood pressure (BP) in patients with Type 2 diabetes on intensive insulin therapy. This study found no significant changes in systolic or diastolic BP with metformin use.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes is often associated with hypertension.
  • Intensive insulin therapy is common for managing Type 2 diabetes.
  • The potential blood pressure-lowering effects of metformin in this patient population are not well-established.

Purpose of the Study:

  • To investigate the effect of metformin on blood pressure (BP) in patients with Type 2 diabetes receiving intensive insulin treatment.
  • To determine if metformin use leads to a significant reduction in systolic BP (SBP) and diastolic BP (DBP).

Main Methods:

  • A double-blind, placebo-controlled study involving 220 patients with Type 2 diabetes.
  • 182 patients consented to 24-hour ambulatory BP monitoring (24-h ABPM).

Related Experiment Videos

  • 89 patients were randomized to metformin, 93 to placebo, with 147 completing 16 weeks of treatment and follow-up ABPM.

    • Main Results:

    • No significant differences in office or 24-h ambulatory BP measurements (SBP, DBP, mean BP, pulse BP, heart rate) between metformin and placebo groups.
    • A non-significant trend towards reduced SBP with metformin was observed (-4.2 mmHg, P=0.15).
    • The only statistically significant finding was a reduction in night-time pulse pressure in the metformin group (-2.2 mmHg).

    Conclusions:

    • Metformin does not significantly impact blood pressure in Type 2 diabetes patients undergoing intensive insulin therapy.
    • The observed non-significant trends and minor significant finding for pulse pressure do not support routine use of metformin for BP reduction in this cohort.