Metformin-associated prevention of weight gain in insulin-treated type 2 diabetic patients cannot be explained by decreased energy intake: a post hoc analysis of a randomized placebo-controlled 4.3-year trial

Mattijs Out, Ida Miedema, Harriët Jager-Wittenaar, Cees van der Schans, Wim Krijnen, Philippe Lehert, Coen Stehouwer, Adriaan Kooy

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Metformin prevents weight gain in patients with type 2 diabetes (T2D). However, the mechanisms involved are still unknown. In this post hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850 mg metformin or received placebo added to insulin (1-3 times daily) for 4.3 years. Dietary intake was assessed at baseline, after 1 year and after 4.3 years, according to the dietary history method. Among the 310 included participants, 179 (93 placebo, 86 metformin) completed all 3 dietary assessments. We found no significant difference in energy intake after 4.3 years between the groups (metformin vs placebo: -31.0 kcal/d; 95% CI, -107.4 to 45.4; F-value, 1.3; df = 415; P = .27). Body weight in placebo users increased significantly more than in metformin-users during 4.3 years (4.9 ± 4.9 vs 1.1 ± 5.2 kg; t test: P ≤ .001). Linear mixed models did not show a significant effect of energy intake as explanation for the difference in weight gain between the groups (F-value, 0.1; df = 1; P = .82). In conclusion, the prevention of weight gain by metformin cannot be explained by reduced energy intake.

Original languageEnglish
Pages (from-to)219-223
JournalDiabetes, obesity & metabolism
Volume20
Issue number1
DOIs
Publication statusPublished - Jan 2018

Keywords

  • diabetes
  • weight gain

Cite this

@article{79c329a980a24060b75dea5a6ee80860,
title = "Metformin-associated prevention of weight gain in insulin-treated type 2 diabetic patients cannot be explained by decreased energy intake: a post hoc analysis of a randomized placebo-controlled 4.3-year trial",
abstract = "Metformin prevents weight gain in patients with type 2 diabetes (T2D). However, the mechanisms involved are still unknown. In this post hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850 mg metformin or received placebo added to insulin (1-3 times daily) for 4.3 years. Dietary intake was assessed at baseline, after 1 year and after 4.3 years, according to the dietary history method. Among the 310 included participants, 179 (93 placebo, 86 metformin) completed all 3 dietary assessments. We found no significant difference in energy intake after 4.3 years between the groups (metformin vs placebo: -31.0 kcal/d; 95{\%} CI, -107.4 to 45.4; F-value, 1.3; df = 415; P = .27). Body weight in placebo users increased significantly more than in metformin-users during 4.3 years (4.9 ± 4.9 vs 1.1 ± 5.2 kg; t test: P ≤ .001). Linear mixed models did not show a significant effect of energy intake as explanation for the difference in weight gain between the groups (F-value, 0.1; df = 1; P = .82). In conclusion, the prevention of weight gain by metformin cannot be explained by reduced energy intake.",
keywords = "diabetes, weight gain, diabetes, gewichtstoename",
author = "Mattijs Out and Ida Miedema and Harri{\"e}t Jager-Wittenaar and {van der Schans}, Cees and Wim Krijnen and Philippe Lehert and Coen Stehouwer and Adriaan Kooy",
note = "{\circledC} 2017 John Wiley & Sons Ltd.",
year = "2018",
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Metformin-associated prevention of weight gain in insulin-treated type 2 diabetic patients cannot be explained by decreased energy intake : a post hoc analysis of a randomized placebo-controlled 4.3-year trial. / Out, Mattijs; Miedema, Ida; Jager-Wittenaar, Harriët; van der Schans, Cees; Krijnen, Wim; Lehert, Philippe; Stehouwer, Coen; Kooy, Adriaan.

In: Diabetes, obesity & metabolism, Vol. 20, No. 1, 01.2018, p. 219-223.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Metformin-associated prevention of weight gain in insulin-treated type 2 diabetic patients cannot be explained by decreased energy intake

T2 - a post hoc analysis of a randomized placebo-controlled 4.3-year trial

AU - Out, Mattijs

AU - Miedema, Ida

AU - Jager-Wittenaar, Harriët

AU - van der Schans, Cees

AU - Krijnen, Wim

AU - Lehert, Philippe

AU - Stehouwer, Coen

AU - Kooy, Adriaan

N1 - © 2017 John Wiley & Sons Ltd.

PY - 2018/1

Y1 - 2018/1

N2 - Metformin prevents weight gain in patients with type 2 diabetes (T2D). However, the mechanisms involved are still unknown. In this post hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850 mg metformin or received placebo added to insulin (1-3 times daily) for 4.3 years. Dietary intake was assessed at baseline, after 1 year and after 4.3 years, according to the dietary history method. Among the 310 included participants, 179 (93 placebo, 86 metformin) completed all 3 dietary assessments. We found no significant difference in energy intake after 4.3 years between the groups (metformin vs placebo: -31.0 kcal/d; 95% CI, -107.4 to 45.4; F-value, 1.3; df = 415; P = .27). Body weight in placebo users increased significantly more than in metformin-users during 4.3 years (4.9 ± 4.9 vs 1.1 ± 5.2 kg; t test: P ≤ .001). Linear mixed models did not show a significant effect of energy intake as explanation for the difference in weight gain between the groups (F-value, 0.1; df = 1; P = .82). In conclusion, the prevention of weight gain by metformin cannot be explained by reduced energy intake.

AB - Metformin prevents weight gain in patients with type 2 diabetes (T2D). However, the mechanisms involved are still unknown. In this post hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850 mg metformin or received placebo added to insulin (1-3 times daily) for 4.3 years. Dietary intake was assessed at baseline, after 1 year and after 4.3 years, according to the dietary history method. Among the 310 included participants, 179 (93 placebo, 86 metformin) completed all 3 dietary assessments. We found no significant difference in energy intake after 4.3 years between the groups (metformin vs placebo: -31.0 kcal/d; 95% CI, -107.4 to 45.4; F-value, 1.3; df = 415; P = .27). Body weight in placebo users increased significantly more than in metformin-users during 4.3 years (4.9 ± 4.9 vs 1.1 ± 5.2 kg; t test: P ≤ .001). Linear mixed models did not show a significant effect of energy intake as explanation for the difference in weight gain between the groups (F-value, 0.1; df = 1; P = .82). In conclusion, the prevention of weight gain by metformin cannot be explained by reduced energy intake.

KW - diabetes

KW - weight gain

KW - diabetes

KW - gewichtstoename

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EP - 223

JO - Diabetes, obesity & metabolism

JF - Diabetes, obesity & metabolism

SN - 1462-8902

IS - 1

ER -