The effects of Metformin Use on Body Mass Index: A Prospective Study

BACKGROUND: Limited number of studies has compared metformin with other Oral Hypoglycemic agents (OHAs) for reducing BMI and few of the results are controversial. Perhaps, this is of clinical importance because the Nepalese population presents different dietary habits in comparison with the European population. The objective of this study was to study the comparative evaluation of metformin with other OHAs influence on Body Mass Index (BMI) in Nepalese patients with diagnosed type 2 Diabetes Mellitus (T2DM)). METHODS: A prospective cross sectional database of patients treated at diabetic clinic, TUTH, was analysed. Patients (N = 115) with type 2 Diabetes Mellitus and with complete BMI and HbA1c and treated with metformin and other OHAs, for at least three visits were included. Analysis of BMI and the type of oral agent was performed. Individuals were categorized as ideal weight, overweight, or obese (BMI <25, 25–29.9, and >30 kg/m2, respectively). RESULTS: There were differences between the values of BMI at presentation, the third, the sixth and the ninth months, between the metformin-treated groups compared to other OHAs treated groups. Metformin was given to 48 patients and OHAs to other 57 patients. In the metformin group, mean BMI decreased significantly during the treatment time, from 29.93±5.7 to 28.95±5.2 (<0.001). The obese the patients, the lower their BMI levels at the end of the analysis period. The mean BMI dropped by 0.9±1.18 in metformin group (from 29.93±5.7 to 24.83±3.6kg/m2; p<0.001). It was found that the patients who had BMI higher than 30 kg/m2 were significantly more likely to lose weight during the metformin therapy (p<0.05). However, the baseline change in body weight observed during metformin treatment correlated with the baseline metabolic control or its improvement during the analysis period. CONCLUSION: Metformin use is associated with a significant decrease in body weight and BMI over long periods of time and it should remain a first choice drug for newly diagnosed T2DM patients, even more so for patients that are overweight or obese. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12309 Ann. Clin. Chem. & Lab. Med. 1(1) 2015: 16-20