Placebo-controlled trial of the effects of guar gum and metformin on fasting blood glucose and serum lipids in obese, type 2 diabetic patients.
Nineteen obese patients with Type 2 diabetes mellitus were treated for periods of 3 months with placebo, guar gum (5 g three times daily) and metformin (500 mg three times daily) in a randomized double-blind, double-placebo, cross-over study. Both active agents decreased fasting blood glucose from 11.4 +/- 3.7 mmol l-1 (mean +/- SD) to 8.6 +/- 2.8 mmol l-1 on metformin (p less than 0.001) and to 9.5 +/- 3.9 mmol l-1 on guar gum (p less than 0.01). Metformin significantly reduced the very low density lipoprotein (VLDL) cholesterol concentration from 0.62 (+0.73, -0.34) mmol l-1 (geometric mean (+SD, -SD)) to 0.43 (+0.58, -0.25) mmol l-1, (p less than 0.02), but unless hyperlipidaemia was present there were no changes in other serum lipid or lipoprotein levels. In patients with serum cholesterol greater than 6.5 mmol l-1 decreases in serum triglycerides from 3.29 (+3.27, -1.64) to 2.46 (+2.55, -1.25) mmol l-1 (p less than 0.02) occurred with metformin. In these patients guar gum produced a reduction in serum cholesterol (from 7.70 +/- 0.90 to 6.41 +/- 1.11 mmol l-1, p less than 0.01) due to an effect on low density lipoproteins. These differential effects may be important in planning therapy when hyperlipidaemia accompanies Type 2 diabetes.
Lalor
B C
BC
University of Manchester Department of Medicine, Manchester Royal Infirmary, UK.
Bhatnagar
D
D
Winocour
P H
PH
Ishola
M
M
Arrol
S
S
Brading
M
M
Durrington
P N
PN
D001055:Apolipoproteins B / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D003927:Diet, Diabetic; D004043:Dietary Fiber / Q000627:therapeutic use*; D005215:Fasting; D005260:Female; D005685:Galactans / Q000627:therapeutic use*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008351:Mannans / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009765:Obesity; D010919:Placebos; D053149:Plant Gums; D014280:Triglycerides / Q000097:blood
D001055:Apolipoproteins B; D001786:Blood Glucose; D008078:Cholesterol, LDL; D004043:Dietary Fiber; D005685:Galactans; D008055:Lipids; D008351:Mannans; D010919:Placebos; D053149:Plant Gums; D014280:Triglycerides; D008687:Metformin; D002784:Cholesterol; C007894:guar gum