Therefore , although the overall effect of metformin on the concentration of serum Hcy was neutral , our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given
The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine ( Hcy ) with and without simultaneous supplementation of B-group vitamins or folic acid .
Comparison of glycaemic control and cardiovascular risk profile in patients with type 2 diabetes during treatment with either repaglinide or metformin.
OBJECTIVE To compare glycaemic control and cardiovascular risk profile in patients with type 2 diabetes following 12 months ' treatment with either repaglinide or metformin . STUDY DESIGN AND METHODS This was an open uncontrolled r and omised study in n=112 patients with inadequately controlled type 2 diabetes not previously treated with oral hypoglycaemic agents . Patients beginning treatment with either repaglinide or metformin entered an 8-week titration period ( to optimise dosage : repaglinide , 2 - 4 mg/day ; metformin , 1500 - 2500 mg/day ) followed by a 12-month treatment period . Glycaemic control and cardiovascular risk factors were determined at baseline and at the end of the treatment period . RESULTS Mean ( S.D. ) final drug doses were 3 ( + /-1 ) mg/day in the repaglinide group and 2000 ( + /-500 ) mg/day in the metformin group . Significant improvements in glycaemic control [ glycated haemoglobin , fasting and 2-h postpr and ial plasma glucose ( PPG ) ] were demonstrated in both treatment groups . The decrease in PPG was significantly greater in the repaglinide group ( P<0.05 ) . During the treatment period , fasting plasma insulin ( FPI ) decreased significantly in both groups , more so with metformin ( P<0.05 ) . Two-hour postpr and ial plasma insulin ( PPI ) levels decreased only in the metformin group ( P<0.05 ) . Significant improvements between baseline and final visit were demonstrated in one or both groups in the following cardiovascular risk factors : total cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , triglycerides , plasminogen activator inhibitor , lipoprotein(a ) and homocysteine . No changes were observed in high-density lipoprotein cholesterol ( HDL-C ) , apolipoprotein A-I , apolipoprotein B , fibrinogen , body mass index ( BMI ) or blood pressure . CONCLUSIONS The use of repaglinide or metformin in drug therapy-nai;ve patients with type 2 diabetes over a 12-month period is associated with improvements in both glycaemic control and cardiovascular risk profile . The latter can not necessarily be attributed to the pharmacotherapy per se , but provides reassurance in the context of initiating oral hypoglycaemic drug therapy with these agents
Therefore , although the overall effect of metformin on the concentration of serum Hcy was neutral , our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given
The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine ( Hcy ) with and without simultaneous supplementation of B-group vitamins or folic acid .