A1 Refereed original research article in a scientific journal

Metformin treatment significantly enhances intestinal glucose uptake in patients with type 2 diabetes: Results from a randomized clinical trial




AuthorsKoffert J., Mikkola K., Virtanen K., Andersson A., Faxius L., Hällsten K., Heglind M., Guiducci L., Pham T., Silvola J., Virta J., Eriksson O., Kauhanen S., Saraste A., Enerbäck S., Iozzo P., Parkkola R., Gomez M., Nuutila P., Nuutila P.

PublisherElsevier Ireland Ltd

Publication year2017

JournalDiabetes Research and Clinical Practice

Journal name in sourceDiabetes Research and Clinical Practice

Volume131

First page 208

Last page216

Number of pages9

ISSN0168-8227

DOIhttps://doi.org/10.1016/j.diabres.2017.07.015

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/26397440


Abstract
Aims

Metformin therapy is associated with diffuse intestinal 18F-fluoro-deoxyglucose (FDG) accumulation in clinical diagnostics using routine FDG-PET imaging. We aimed to study whether metformin induced glucose uptake in intestine is associated with the improved glycaemic control in patients with type 2 diabetes. Therefore, we compared the effects of metformin and rosiglitazone on intestinal glucose metabolism in patients with type 2 diabetes in a randomized placebo controlled clinical trial, and further, to understand the underlying mechanism, evaluated the effect of metformin in rats.

Methods

Forty-one patients with newly diagnosed type 2 diabetes were randomized to metformin (1 g, b.i.d), rosiglitazone (4 mg, b.i.d), or placebo in a 26-week double-blind trial. Tissue specific intestinal glucose uptake was measured before and after the treatment period using FDG-PET during euglycemic hyperinsulinemia. In addition, rats were treated with metformin or vehicle for 12 weeks, and intestinal FDG uptake was measured in vivo and with autoradiography.

Results

Glucose uptake increased 2-fold in the small intestine and 3-fold in the colon for the metformin group and associated with improved glycemic control. Rosiglitazone increased only slightly intestinal glucose uptake. In rodents, metformin treatment enhanced intestinal FDG retention (P = 0.002), which was localized in the mucosal enterocytes of the small intestine.

Conclusions

Metformin treatment significantly enhances intestinal glucose uptake from the circulation of patients with type 2 diabetes. This intestine-specific effect is associated with improved glycemic control and localized to mucosal layer. These human findings demonstrate directs effect of metformin on intestinal metabolism and elucidate the actions of metformin.


Downloadable publication

This is an electronic reprint of the original article.
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Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.





Last updated on 2024-26-11 at 21:26