Document Detail


Safety and efficacy of metformin in a restricted formulary.
MedLine Citation:
PMID:  10345968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the efficacy and safety of metformin (MET) in the Veterans' Administration Northern California Health Care System during the period from June 1995 through April 1996 when its use required approval by Endocrinology. STUDY DESIGN: A retrospective review of patient charts and computerized pharmacy and laboratory records. Patients served as their own historical controls. PATIENTS AND METHODS: Patients receiving MET (n = 251) were identified from the pharmacy database. On-line laboratory data, including the intermediate outcome variable HbA1c, were retrieved by computer for the interval 4 months prior to the initial prescription to May 1996. Clinical data including weight and blood pressure were obtained from chart review. RESULTS: Of 228 patients whose charts were available for review, 29 reported side effects, and 12 discontinued use due to these side effects. No patients were identified with lactic acidosis. Both baseline and treatment data on HbA1c were available on 164 patients. Mean HbA1c (%) data (unpaired), expressed as mean +/- SE, were as follows: between 4 months pretreatment and 1 month pretreatment, 9.41 +/- 0.19 (n = 103 tests); between 1 month pretreatment and baseline, 9.41 +/- 0.19 (n = 110 tests); 3 months of treatment, 8.79 +/- 0.16 (n = 157 tests, P < 0.05); 6 months of treatment, 8.30 +/- 0.17 (n = 79 tests, P < 0.0001); 9 months of treatment, 8.72 +/- 0.24 (n = 70 tests, P < 0.05), compared to pretreatment values. Similar analysis of unpaired weight and blood pressure data in 152 patients did not reveal any reduction in these clinical parameters over this treatment period. Serum lipids were unchanged on treatment (by paired analysis), but the number of tests was limited. CONCLUSION: In this setting, MET provided sustained beneficial effects on glycemic control and was well tolerated. Any effects on weight, blood pressure, and serum lipids were not demonstrable in this analysis. We conclude that MET can substantially improve outcome of diabetes care.
Authors:
A L Swislocki; Q Khuu; E Liao; E Wu; F Beza; J Lopez; G Kwan; R H Noth
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of managed care     Volume:  5     ISSN:  1088-0224     ISO Abbreviation:  Am J Manag Care     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-04-07     Completed Date:  1999-04-07     Revised Date:  2005-07-26    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  62-8     Citation Subset:  H    
Affiliation:
VA Northern California Health Care System (VANCHCS), Martinez, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Body Weight
California
Diabetes Mellitus, Type 2 / drug therapy*,  physiopathology
Female
Formularies, Hospital*
Hemoglobin A, Glycosylated / analysis
Hospitals, Veterans
Humans
Hypoglycemic Agents / adverse effects,  therapeutic use*
Male
Metformin / adverse effects,  therapeutic use*
Middle Aged
Pharmacy Service, Hospital
Retrospective Studies
Safety
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 657-24-9/Metformin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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