The Effect of Metformin on the Incidence of Type 2 Diabetes Mellitus and Cardiovascular Disease Risk Factors in Overweight and Obese Subjects The Carmos Study

We investigated whether the addition of metformin to the treatment of Overweight and obese individuals further reduces the incidence of type 2 diabetes mellitus (T2DM), prediabetes and metabolic syndrome (MetS) and improves Cardiovascular disease (CVD) risk factors (RFs). Design and methods: We studied 366 adults (mean age 53.0 +/- 0.5 SE years, and mean BMI 32.3 +/- 0.2 SE Kg/m(2)) Without CVD. All Subjects received lifestyle recommendations and drug management of CVD-RFs, whilst 95 of them were additionally given metformin. The follow-up period lasted 12 months. Results: At the end Of the Study the frequency of T2DM in the metformin and non-metformin group Was 1.1 and 8.1%, respectively (risk difference = -7% with 95% CI from -12.7% to -1.4%, p=0.012). Participants with prediabetes displayed a greater reduction in the incidence of T2DM after taking metformin compared to those who had not received this drug (risk difference = -18.5% with 95%CI from -33.1% to -3.9%, p=0.010). Metformin had a similar beneficial impact on Subjects with MetS (risk difference = -12.9% with 95% from -25% to -0.7%, p=0.040) and this was attributed to the greater increase in HDL-C (p=0.046) and decrease in fasting plasma glucose levels (p=0.024). Metformin also achieved a greater reduction in total cholesterol and LDL-C levels (metformin vs. non-metformin treated subjects: -31.9 vs. -17.3 mg/dl, p=0.001, and -26.2 vs. -15.9 mg/dl, p=0.006. respectively). Conclusions: Metformin reduces the occurrence of T2DM in Overweight and obese non-diabetic adults and decreases the rate of MetS by improving the CVD risk factor profile.