Metabolic Effects of Combined Sulphonylurea and Metformin Therapy in Maturity-Onset Diabetics

Abstract

Twelve hour metabolic studies were performed in 2 groups of [human] maturity-onset diabetics treated either by sulfonylurea and metformin therapy or sulfonylurea therapy alone. There was no significant difference in blood glucose concentration between the 2 groups although serum insulin concentration was significantly higher in the group treated by sulfonylurea therapy alone. Concentrations of several intermediary metabolites were higher when metformin formed part of the therapy. Thus, mean blood lactate, pyruvate, Ala and total ketone body concentrations and the lactate/pyruvate ratio and 3-hydroxybutyrate/acetoacetate ratio were all significantly elevated during sulfonylurea and metformin therapy. The use of metformin with a sulfonylurea results in widespread abnormalities in blood concentrations of intermediary metabolites.