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Is metformin safe enough for ageing type 2 diabetic patients?
F Gregorio1, F Ambrosi, P Filipponi
1Anti-Diabetic Unit, E. Profili General Hospital, Fabriano (AN), Italy.
Diabetes & Metabolism
|February 1, 1996
Summary
Adding low-dose metformin to sulfonylurea therapy significantly improves glycemic control in elderly patients with Type 2 diabetes. This combination is well-tolerated and offers additional benefits like weight loss, with lactate levels remaining safe.
Area of Science:
- Gerontology
- Endocrinology
- Pharmacology
Background:
- Elderly patients with Type 2 diabetes often require complex management.
- Concerns exist regarding metformin use in older adults due to potential lactate accumulation.
Purpose of the Study:
- To evaluate the efficacy and safety of low-dose metformin combined with sulfonylurea in elderly Type 2 diabetic patients.
- To assess the impact on glycemic control, blood lactate levels, and other metabolic parameters.
Main Methods:
- A one-year study involving 76 elderly Type 2 diabetic patients.
- Monitoring of glycemic control (e.g., HbA1c) and blood lactate concentrations.
- Assessment of lipid profiles, serum uric acid, and body weight.
Main Results:
- Metformin significantly improved glycemic control.
- Fasting lactate levels were unaffected; post-meal lactate peaks showed minimal increase.
- Positive effects observed on lipid parameters, reduced uric acid, and significant weight loss in overweight patients.
- Metformin was clinically well-tolerated.
Conclusions:
- Low-dose metformin is a safe and effective adjunct to sulfonylurea therapy in elderly Type 2 diabetic patients.
- Renal function and age-related factors, not age alone, should guide metformin prescription.
- Metformin should not be routinely denied to older adults with Type 2 diabetes.