Unique Glycemic and Cardio-Renal Protective Effects of Metformin Therapy among Type-2 Diabetic Patients with Association of High Non-Hdl-Cholesterol and Low Hba1c, Serum Creatinine and Spot Urine Protein: A Lesson from a Five Year Cross Sectional Observational Study of 1590 Patients

Metformin is currently considered a first line therapy for managing type-2 diabetes for targeting insulin resistance and obesity. However, in usual busy clinical practice, the importance of metformin is sometimes ignored and patients are prescribed directly OHA or shifted to insulin therapy without metformin. Metformin has been shown to counteract dyslipidemia and as a drug for cardiac and renal protection as well. Current research was planned to enroll type-2 patients who were additionally prescribed metformin (with other OHA/insulins) compared to those who were not on metformin; and to compare HbA1c lipids, creatinine, spot urine protein and spot urine protein/creatinine between these two groups of patients. Study included 1590 patients and data were collected for the period of 5 years (January 2009 till January 2014) in the diabetology clinic ofAseer Diabetes Center at initial visits by standardized methodology. Type-1 DM, children (<13 years), pregnant, chronic renal failure, ESRD, and patients intolerant to metformin were excluded from the study. It was observed that 581 (36.6%) type-2 DM subjects were not prescribed metformin. Levels of HbA1c and BMI were lower in the metformin group compared to those without metformin (9.47 ± 2and 27.35versus 9.74± 2.4 and 30.25 ± 5.72; p-values 0.004 and < 0.0001 respectively). Non-HDL-C values were higher for the metformin group (152.6 ± 48 versus 140.4 ± 44; p<0.0001). Levels of creatinine, spot urine protein and spot urine protein/creatinine was higher for the group without metformin therapy (1.1 ± 0.31, 95.23 ± 138, 1.143 ± 3.39 versus 0.89 ± 0.2, 38.92 ± 82.17, 0.425 ± 1.25 with p-values <0.0001, 0.017 and 0.015 respectively). In the current study, metformin provided unique Glycemic and lipid control and cardio-renal protection among type-2 DM patients and should be prescribed to type-2 DM patients while managing diabetes to prevent complications of diabetes. Special Issue on Antidiabetic DrugMetformin