OBJECTIVE: Abnormalities of lipid metabolism are common among patients with type
2 diabetes mellitus; these abnormalities increase the risk of morbidity and mortality from
ischemic heart diseases. Insulin resistance is an important cause of abnormal carbohydrate
and lipid metabolism. Metformin improves glycemic control in patients with type 2
diabetes mellitus without affecting serum insulin levels. It may produce its effect by
decreasing insulin resistance. This study was conducted to observe effects of metformin
on lipid profile in patients with type 2 diabetes mellitus; as drug decreases insulin
resistance, which is an important cause of lipid abnormalities.
SETTING: Fourteen patients with type 2 diabetes mellitus taking oral antidiabetic agents
were selected. Antidiabetic drugs were stopped for one week and metformin was started
with a dose of 500 mg/day, dose of the drug was titrated according to glycemic control.
All participants received metformin for three weeks. Blood glucose, serum insulin,
cholesterol, triglycerides, HDL, LDL and VLDL cholesterol were determined before and
after metformin therapy.
RESULTS: After three week therapy with metformin serum total cholesterol and LDL
cholesterol reduced (P < 0.004 and < 0.001 respectively), HDL cholesterol elevated
significantly (P < 0.002) and blood glucose reduced significantly (P < 0.005). However,
no significant changes in serum insulin, triglyceride and VLDL cholesterol were observed.
CONCLUSION: Elevation in LDL cholesterol and reduction in HDL cholesterol levels
are commonly associated with atheromatous lipid profile. The results of this work
indicate that metformin therapy change these parameters favorably.
KEY WORDS: Metformin, Type 2 diabetes mellitus, serum insulin
High Density Lipoprotein.
Low Density Lipoprotein.
VLDL: Very Low Density Lipoprotein.
Diabetes mellitus is a chronic metabolic disorder that results either from absolute
deficiency of insulin (Type 1) or from im