Metformin for typediabetes patients or not? Researchers now have the
answer

Date:
September 17, 2020
Source:
Lund University
Summary:
Metformin is the first-line drug that can lower blood sugar levels
in type 2 diabetes patients. One third of patients do not respond to
metformin treatment and 5 per cent experience serious side effects,
which is the reason many choose to stop medicating. Researchers
have now identified biomarkers that can show in advance how the
patient will respond to metformin treatment via a simple blood test.



FULL STORY ========================================================================== Metformin is the first-line drug that can lower blood sugar levels in type
2 diabetes patients. One third of patients do not respond to metformin treatment and 5 per cent experience serious side effects, which is the
reason many choose to stop medicating. Researchers at Lund University
in Sweden have now identified biomarkers that can show in advance how
the patient will respond to metformin treatment via a simple blood test.


==========================================================================
"Our study constitutes an important step towards the goal of personalised
care for diabetes patients because it can contribute to ensuring that the
right person receives the right care as soon as there is a diagnosis,"
says Charlotte Ling, professor of epigenetics at Lund University, who
led the study.

When diet and exercise are not enough to regulate blood sugar, metformin
is the first drug introduced to treat type 2 diabetes, according to international guidelines. If it does not have the intended effect in
the form of lowered blood sugar levels, or if the patient experiences
serious side effects, patients then go on to trial other drugs.

"If it takes a long time for the patient to receive the correct treatment, there is a risk of complications due to the elevated blood sugar levels.

Approximately 30 per cent of all patients with type 2 diabetes do not
respond to metformin and should be given another drug right from the
start. For this reason, it is important to be able to identify these
patients upon diagnosis," says Charlotte Ling.

One third of patients experience side effects usually in the form
of gastrointestinal difficulties such as nausea, stomach pain and
diarrhea. Five per cent stop taking the medicine due to severe side
effects.

The study is the first pharmacoepigenetic study in diabetes, i.e. that researchers have studied how epigenetic factors, such as DNA methylation
(see fact box), can be used as biomarkers to predict the effect of a drug.

"To a certain extent, pharmacoepigenetics has been used within cancer
care to predict how a person will respond to a treatment, however,
it has never been done in diabetes care before," says Charlotte Ling.

Researchers in the study have looked at epigenetic modifications,
so-called DNA methylations, in blood from individuals diagnosed with
diabetes before they started taking metformin. In a follow-up a year
later, the researchers could see which patients had benefited from the treatment (with resulting lowered blood sugar levels) and whether or
not they had suffered from side effects.

"By compiling the responses, we have found biomarkers that can identify
already at diagnosis of diabetes which patients will benefit from and
tolerate metformin, which will advance personalised therapy in type 2 diabetes," says the study's first author Sonia Garci'a-Calzo'n.

The study was conducted on 363 participants from three different patient cohorts (All New Diabetics in Skaane, All New Diabetics in Uppsala and
Optimed from Latvia). As a next step, the researchers are planning for
a new clinical study in which they will repeat the study with a larger
patient group -- 1000 patients will be invited to participate from all
around the world.


========================================================================== Story Source: Materials provided by Lund_University. Note: Content may
be edited for style and length.


========================================================================== Journal Reference:
1. Sonia Garci'a-Calzo'n, Alexander Perfilyev, Mats Martinell, Monta
Ustinova, Sebastian Kalamajski, Paul W. Franks, Karl Bacos,
Ilze Elbere, Jussi Pihlajama"ki, Petr Volkov, Allan Vaag,
Leif Groop, Marlena Maziarz, Janis Klovins, Emma Ahlqvist,
Charlotte Ling. Epigenetic markers associated with metformin
response and intolerance in drug-nai"ve patients with type 2
diabetes. Science Translational Medicine, 2020; 12 (561): eaaz1803
DOI: 10.1126/scitranslmed.aaz1803 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/09/200917105333.htm

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