Metformin prolongs the postprandial fall in plasma ghrelin concentrations in type 2 diabetes.
BACKGROUND
Weight loss is difficult to achieve in type 2 diabetes and many therapies are associated with weight gain, an effect attenuated by metformin. We studied the effects of metformin on energy expenditure, appetite and the regulation of PYY and ghrelin in type 2 diabetes.


METHODS
Plasma peptide YY (PYY), ghrelin, resting metabolic rate (RMR), postprandial thermogenesis (PPTG), and appetite ratings were measured at baseline and following a mixed meal in 11 type 2 diabetic subjects treated with diet alone (T2D) and 10 treated with metformin monotherapy (T2MF). The groups were similar in age, gender and adiposity.


RESULTS
There were no differences in baseline anthropometric, or metabolic variables between the groups. Postprandially, plasma ghrelin fell equally in both groups (23% versus 24.5%, p < 0.05 versus baseline, p = NS between groups) but were reduced for longer in T2MF (below baseline 60-240 min T2MF versus 60-180 min T2D) coincidentally with a prolonged sensation of fullness and suppression of hunger in the metformin-treated group. There were no differences in PYY concentrations, RMR or PPTG.


CONCLUSIONS
Metformin prolongs the postprandial fall in ghrelin concentrations. These effects may prolong the inter-meal interval, thereby decreasing snack intake and daily energy intake, promoting weight loss.
English
P J
PJ
Diabetes and Endocrinology Research Group, University Hospital Aintree, Liverpool, UK.
Ashcroft
A
A
Patterson
M
M
Dovey
T M
TM
Halford
J C G
JC
Harrison
J
J
Eccleston
D
D
Bloom
S R
SR
Ghatei
M A
MA
Wilding
J P H
JP
D000328:Adult; D001066:Appetite; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D004734:Energy Metabolism / Q000187:drug effects; D005260:Female; D054439:Ghrelin; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009994:Osmolar Concentration; D036361:Peptide Hormones / Q000097:blood*; D019894:Peptide YY / Q000097:blood; D019518:Postprandial Period; D012528:Satiety Response; D022722:Thermogenesis
D054439:Ghrelin; D007004:Hypoglycemic Agents; D036361:Peptide Hormones; D019894:Peptide YY; D008687:Metformin