Evidence map›Paper›PMID 7623903›Full record

ArticleThe New England journal of medicine1995

Metabolic effects of metformin in non-insulin-dependent diabetes mellitus.

M Stumvoll, N Nurjhan, G Perriello, G Dailey, J E Gerich

4 registry-linked trialsOpen access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in The New England journal of medicine, 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 283 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
283citing papers in PubMed, 9 pooled it
13.2field-weighted citation impact, top 1% 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.

NCT03968224 phase2 / phase3completedstarted 2018, after this paper: background citation

Effectiveness of the Treatment With Dapagliflozin and Metformin Compared to Metformin Monotherapy for Weight Loss on Diabetic and Prediabetic Patients With Obesity Class III

Ran2018Enrolled160Registered outcomes7Posted comparisons4ConditionsDiabetes Mellitus, Type 2, Obesity, Morbid, PrediabetesArmsDapagliflozin/Metformin, Metformin
PMID 27333994PMID 25015317PMID 30742570PMID 24144654PMID 26203064PMID 24919526PMID 22238392PMID 7623902PMID 11118008PMID 24463454PMID 11975807PMID 16219009other papers from this trial
Open the trial in the graph
NCT04626089 phase2withdrawnstarted 2021, after this paper: background citation

Adaptive Study for Efficacy and Safety of Metformin Glycinate for the Treatment of Patients With MS and DM2, Hospitalized With Severe Acute Respiratory Syndrome Secondary to SARS-CoV-2. Randomized, Double-Blind, Phase IIIb.

Ran2021Enrolled0Registered outcomes12Posted comparisons0ConditionsMetabolic Syndrome, Severe Acute Respiratory Syndrome Coronavirus 2, Type 2 DiabetesArmsMetformin glycinate, Placebo Oral Tablet
PMID 7996443PMID 30414960PMID 22974412PMID 17941868PMID 9030834PMID 19538242PMID 19918015PMID 8269798PMID 2648723PMID 12086935PMID 20577053PMID 16308421other papers from this trial
Open the trial in the graph
NCT00941239 phase1completednot on this mapstarted 2007, after this paper: background citation

Gastric Tolerability and Pharmacokinetics of an Extended Release Metformin and an Immediate Release Metformin

TypeinterventionalSponsorLaboratorios Silanes S.A. de C.V.Ran2007 to 2007Enrolled24ConditionsHealthyArmsmetformin ER, metformin
NCT06611501 phase2active not recruitingnot on this mapstarted 2025, after this paper: background citation

Glycemic Regulation as Endometriosis Adjunct Treatment

TypeinterventionalSponsorBoston Children's HospitalRan2025 to 2027Enrolled14ConditionsPelvic Pain, EndometriosisArmsMetformin Hydrochloride, Placebo
3 · Its place in the literature

Who cites it

283 citing papers in PubMed, 9 syntheses or guidelines pooled it, 1,140 citations in OpenAlex.

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  4. The effect of metformin on biomarkers associated with breast cancer outcomes: a systematic review, meta-analysis, and dose-response of randomized clinical trials.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2020 · on this map
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223 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

M StumvollUniversity of Rochester School of Medicine, New York 14642, USA.
N Nurjhan
G Perriello
G Dailey
J E Gerich
University of Rochester · US

Funding

YOHIMBINE CHALLENGE IN PARKINSONIAN PATIENTS WITH PANIC DISORDERM01RR000044 · UNIVERSITY OF ROCHESTER · 1985 to 2005
$13.3M
WHOLE BODY PROTEIN KINETICS IN HIV INFECTED MALAWIAN CHILDRENP41RR000954 · WASHINGTON UNIVERSITY · 1985 to 2005
$6.6M
ALPHA AND BETA CELL FUNCTION IN NORMAL AND DIABETIC MANR01DK020411 · UNIVERSITY OF ROCHESTER · 1996 to 2005
$1.6M
ALPHA AND BETA CELL FUNCTION IN HUMAN DIABETESR37DK020411 · WHITTIER INSTITUTE FOR DIABETES &ENDOC · 1986 to 1993
–
NCRR NIH HHS 5MO1-RR 00044NCRR NIH HHS 5MO1-RR 000954NIDDK NIH HHS DK-20411
6 · The paper itself

Abstract

backgroundThe metabolic effects and mechanism of action of metformin are still poorly understood, despite the fact that it has been used to treat patients with non-insulin-dependent diabetes mellitus (NIDDM) for more than 30 years.

methodsIn 10 obese patients with NIDDM, we used a combination of isotope dilution, indirect calorimetry, bioimpedance, and tissue-balance techniques to assess the effects of metformin on systemic lactate, glucose, and free-fatty-acid turnover; lactate oxidation and the conversion of lactate to glucose; skeletal-muscle glucose and lactate metabolism; body composition; and energy expenditure before and after four months of treatment.

resultsMetformin treatment decreased the mean (+/- SD) glycosylated hemoglobin value from 13.2 +/- 2.2 percent to 10.5 +/- 1.6 percent (P < 0.001) and reduced fasting plasma glucose concentrations from 220 +/- 41 to 155 +/- 28 mg per deciliter (12.2 +/- 0.7 to 8.6 +/- 0.5 mmol per liter) (P < 0.001). Although resting energy expenditure did not change, the patients lost 2.7 +/- 1.3 kg of weight (P < 0.001), 88 percent of which was adipose tissue. The mean (+/- SE) rate of plasma glucose turnover (hepatic glucose output and systemic glucose disposal) decreased from 2.8 +/- 0.2 to 2.0 +/- 0.2 mg per kilogram of body weight per minute (15.3 +/- 0.9 to 10.8 +/- 0.9 mumol per kilogram per minute) (P < 0.001), as a result of a decrease in hepatic glucose output; systemic glucose clearance did not change. The rate of conversion of lactate to glucose (gluconeogenesis) decreased by 37 percent (P < 0.001), whereas lactate oxidation increased by 25 percent (P < 0.001). There were no changes in the plasma lactate concentration, plasma lactate turnover, muscle lactate release, plasma free-fatty-acid turnover, or uptake of glucose by muscle.

conclusionsMetformin acts primarily by decreasing hepatic glucose output, largely by inhibiting gluconeogenesis. It also seems to induce weight loss, preferentially involving adipose tissue.

Indexed as

ObesityBlood GlucoseBody CompositionDiabetes MellitusDiabetes Mellitus, Type 2Energy MetabolismFemaleGlucoseGlycated HemoglobinHumansLactatesLactic AcidMaleMetforminMiddle AgedMuscle, SkeletalBlood GlucoseGlucoseGlycated HemoglobinLactatesLactic AcidMetformin

Identifiers

PMID7623903
OpenAlexW2315982688

What Socratic holds

Texttitle and abstract
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.