Possibility for the Metformin administration in post-infarction period in patients with the 2-nd type of DM
Natallia Yaroshevich, Anastasiya Hlazkova, Larissa Danilova, Irina Burko & Anastasiya Hlazkova
In our study during the period of 6 months we were monitoring lactate and other biochemical parameters levels in patients with diabetes mellitus and myocardial infarction after introducing Metformin into their treatment protocols.
Fifteen persons with the DM 2 (eight males and seven females) were included into the first group. Metformin was administrated in a daily dosage of 1700 mg. Some patients (7/15) were receiving antidiabetic therapy with the sulphonyl urea of the second generation - Gliclazide in the dosage from 60 to 120 mg/day. Second control group has been formed by 19 patients with DM 2 (11 males and 8 females), after myocardial infarction, receiving only Gliclazide, without Metformin.
On each visit we evaluated the body weight, waist and hip measurements, contamination of the visceral fat (%), blood pressure, fasting glycemia, HbA1c, Total Cholesterol (TC), triglycerides (TG), cholesterol of the lipoproteins of low density (LDLP), cholesterol of the lipoproteins of high density (HDLP) and basal insulinemia level (IRI). Insulin resistance index - Homeostasis model assessment (HOMAIR) has been calculated according to standard formula.
Results: i) During the administration of Metformin to the complex therapy of the patients with DM2 in post infarction period we did not registered any case of lactate of creatinine elevation for the duration of the whole follow-up period. ii) Myocardial infarction except the acute phase cannot be considered as contraindication to Metformin administration. iii) During the Metformin administration for the period of 6 months we observed significant decrease of the insulin resistance index (HOMAIR), HbA1c levels and decrease of the serum level of TG, TC and LPLD.