title: Effectiveness of metformin and lifestyle interventions as an initial treatment in Japanese patients with newly diagnosed type 2 diabetes: a prospective observational study.
abstract: Although global guidelines recommend metformin and lifestyle interventions as an initial treatment in patients with newly diagnosed type 2 diabetes (T2DM), few reports exist about its effectiveness in Japanese patients. To examine its effectiveness, we performed a prospective observational study within a routine clinical setting. We provided metformin (≥1,500 mg/day) and lifestyle interventions to 23 patients with newly diagnosed T2DM (20 men and 3 women, mean age 53 years, mean body mass index [BMI] 25.7 kg/m(2)). After 16 weeks, HbA1c levels significantly decreased from 9.1±2.1% (mean±SD) to 6.6±0.8% (p<0.001). Thirteen patients (56.5%) achieved a target HbA1c<6.5%. We did not find a significant correlation between baseline BMI and the changes in HbA1c (ΔHbA1c) (r=-0.165, p=0.451). In contrast, we found a significant correlation between baseline fasting plasma glucose and ΔHbA1c (r=-0.755, p<0.001). Body weight decreased from 73.3±13.3 kg to 69.8±11.6 kg (p<0.001). Total cholesterol, low density lipoprotein - cholesterol, non-high density lipoprotein-cholesterol, and serum vitamin B-12 concentrations also significantly decreased. Adverse events included diarrhea (26.1%) and mild elevation of liver enzymes (8.7%). These results suggest that metformin and lifestyle interventions is effective and safe as an initial treatment in Japanese patients with newly diagnosed T2DM.
authors.affiliation: Center for Preventive Medicine, Nissay Hospital, Osaka, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Sumitani
authors.forename: Shinya
authors.initials: S
authors.lastname: Morita
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Utsu
authors.forename: Kosuke
authors.initials: K
authors.lastname: Mukai
authors.forename: Shunji
authors.initials: S
authors.lastname: Miki
authors.forename: Bunzo
authors.initials: B
authors.lastname: Sato
authors.forename: Hideji
authors.initials: H
authors.lastname: Nakamura
authors.forename: Soji
authors.initials: S
authors.lastname: Kasayama
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin