Evidence map›Paper›PMID 27862873›Full record

Trial reportDiabetes, obesity & metabolism2017

Sustained influence of metformin therapy on circulating glucagon-like peptide-1 levels in individuals with and without type 2 diabetes.

David Preiss, Adem Dawed, Paul Welsh, Alison Heggie, Angus G Jones, Jacqueline Dekker, Robert Koivula, Tue H Hansen, Caitlin Stewart, Rury R Holman and 5 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00723307. Cited by 29 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 1 pooled it
5.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00723307 phase4completed

A Randomised Placebo-controlled Trial of Metformin on Progression of Carotid Atherosclerosis in Non-diabetic Patients With Cardiovascular Disease Treated With Conventional Risk Reducing Agents

Ran2009Enrolled173Registered outcomes4Posted comparisons0ConditionsCoronary Artery DiseaseArmsMetformin, Placebo
Open the trial in the graph
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.

  1. Pooled it
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  5. Current and emerging strategies for the prevention of hepatocellular carcinoma.Nature reviews. Gastroenterology & hepatology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 4 countries.

David PreissMRC Population Health Research Unit, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Health, University of Oxford, Oxford, UK.
Adem DawedDivision of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK.
Paul WelshBHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Alison HeggieInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Angus G JonesNIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK.
Jacqueline DekkerDepartment of Epidemiology and Biostatistics, VU Medical Center, Amsterdam, The Netherlands.
Robert KoivulaDepartment of Clinical Sciences, Genetic and Molecular Epidemiology, Lund University, Malmö, Sweden.
Tue H HansenSection of Metabolic Genetics, Faculty of Health Sciences, Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
Caitlin StewartBHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Rury R HolmanDiabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Paul W FranksDepartment of Clinical Sciences, Genetic and Molecular Epidemiology, Lund University, Malmö, Sweden.
Mark WalkerInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Ewan R PearsonDivision of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK.
Naveed SattarBHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
DIRECT consortium group
British Heart Foundation · GBLund University · SENewcastle University · GBUniversity of Dundee · GBAmsterdam UMC Location VUmc · NLNuffield Health · GBUniversity of Copenhagen · DKUniversity of Exeter · GBUniversity of Glasgow · GBUniversity of Oxford · GB

Funding

Chief Scientist Office CZB/4/613Wellcome TrustWellcome Trust 102820/Z/13/Z
6 · The paper itself

Abstract

aimsTo investigate, in the Carotid Atherosclerosis: Metformin for Insulin Resistance (CAMERA) trial (NCT00723307), whether the influence of metformin on the glucagon-like peptide (GLP)-1 axis in individuals with and without type 2 diabetes (T2DM) is sustained and related to changes in glycaemia or weight, and to investigate basal and post-meal GLP-1 levels in patients with T2DM in the cross-sectional Diabetes Research on Patient Stratification (DIRECT) study. MATERIALS AND

methodsCAMERA was a double-blind randomized placebo-controlled trial of metformin in 173 participants without diabetes. Using 6-monthly fasted total GLP-1 levels over 18 months, we evaluated metformin's effect on total GLP-1 with repeated-measures analysis and analysis of covariance. In the DIRECT study, we examined active and total fasting and 60-minute post-meal GLP-1 levels in 775 people recently diagnosed with T2DM treated with metformin or diet, using Student's t-tests and linear regression.

resultsIn CAMERA, metformin increased total GLP-1 at 6 (+20.7%, 95% confidence interval [CI] 4.7-39.0), 12 (+26.7%, 95% CI 10.3-45.6) and 18 months (+18.7%, 95% CI 3.8-35.7), an overall increase of 23.4% (95% CI 11.2-36.9; P < .0001) vs placebo. Adjustment for changes in glycaemia and adiposity, individually or combined, did not attenuate this effect. In the DIRECT study, metformin was associated with higher fasting active (39.1%, 95% CI 21.3-56.4) and total GLP-1 (14.1%, 95% CI 1.2-25.9) but not post-meal incremental GLP-1. These changes were independent of potential confounders including age, sex, adiposity and glycated haemoglobin.

conclusionsIn people without diabetes, metformin increases total GLP-1 in a sustained manner and independently of changes in weight or glycaemia. Metformin-treated patients with T2DM also have higher fasted GLP-1 levels, independently of weight and glycaemia.

Indexed as

AdultAgedBlood GlucoseBody WeightCase-Control StudiesDiabetes Mellitus, Type 2Double-Blind MethodFastingFemaleGlucagon-Like Peptide 1Glycated HemoglobinHumansHypoglycemic AgentsIntercellular Signaling Peptides and ProteinsMaleMetforminBlood GlucoseCKGGRAKDC-GG-D(KLAKLAK)2Glucagon-Like Peptide 1Glycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsIntercellular Signaling Peptides and ProteinsMetforminPeptidesantidiabetic drugGLP-1metformin

Identifiers

PMID27862873
PMCPMC5330429
OpenAlexW2549087520

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.