[Metformin in the treatment of type 2 diabetes in overweighted or obese patients]

FUNDAMENTALS AND OBJECTIVES: [corrected] Diabetes is the disease that has suffered a greater increase in his incidence in the last years. Obesity is the most important risk factor to develop this disease and metformin is considered as a first line drug in overweighted diabetic patients. The aim of this study is to evaluate the use of metformin and the degree of control of the associated cardiovascular risk factors (CVRF) in patients suffering of type 2 diabetes and overweight or obesity.

This is a transversal descriptive study over a random chosen group of 308 patients followed at primary care level. They were classified in four different groups depending on the treatment used to control them (diet, insulin, metformin and other oral antidiabetic drugs). They were evaluated upon the degree of control of the modifiable CVRF, the presence of complications and the metabolic control.

The average age was 69.6 years, 54% of the patients female. 36.6% followed treatment with metformin and 40.5% with sulfonylureas. The macrovascular percentage of affection was 19.4%. The most frequent CVRF was arterial hypertension (76%). The goal levels of control that were less in range were the levels of cLDL < 100 mg/dl and systolic blood pressure < 130 mmHg. Diabetic patients only treated with diet had a better control of fasten glycemia and HbA1c% than those ones treated with metformin (p < 0.001). The group treated with metformin showed levels of triglycerides (TG) significantly higher than those of the diet controlled group (p = 0.009) and insulin group (p < 0.001).

Metformin and sulfonylureas are used in a similar proportion in type 2 diabetics with overweight or obesity. There is a poor control of the majority of the CVRF in the diabetic population studied.