Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2008) 15 P130

SFEBES2008 Poster Presentations Diabetes, metabolism and cardiovascular (51 abstracts)

Effect of ingestion of food on the inhibition of DPPIV activity by oral metformin in type 2 diabetes

Joy Cuthbertson 1 , Steven Patterson 2 , Finbarr O’Harte 2 & Patrick Bell 1


1Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK; 2School of Biomedical Sciences, University of Ulster, Coleraine, UK.


The incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) constitute the enteroinsular axis which promotes postprandial insulin secretion. The therapeutic potential of these hormones in diabetes is limited by their rapid inactivation by the enzyme dipeptidylpeptidase-IV (DPP-IV). Here we investigated the acute effects of metformin in the presence and absence of food on DPP-IV activity in type 2 diabetes.

Ten subjects with type 2 diabetes (6 male/4 female, age 65.8±15.8 years (mean±S.E.M.), body mass index 30.0±7.5 kg/m2, HbA1c 6.3±1.2%) received metformin 1 g orally or placebo together with a standard mixed meal (SMM) in a random crossover design. Six subjects reattended fasting and received metformin 1 g without a SMM.

Following SMM (n=10), DPP IV activity was not suppressed by metformin compared with placebo (area under curve AUC 0-4h 1574±4 and 1581±8 μmol/min respectively). No differences were observed in plasma glucose, insulin and total GLP-1. After fasting (n=6), DPP IV activity was suppressed (P<0.02) when compared to those given metformin with a SMM (AUC 0-4h 1494±9 vs 1578±4 μmol/min). Metformin plasma levels were significantly higher (P<0.03) after fasting than SMM (AUC 0-4h 457±55 vs 350±66 mcg/ml).

Thus metformin inhibits DPP IV activity in type 2 diabetic patients in the fasting state but not when taken with a standard mixed meal. Metformin plasma concentrations are lower if taken with food. Metformin may have potential for combination therapy with incretin hormones.

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