Metformin-associated prevention of weight gain in insulin-treated type 2 diabetic patients cannot be explained by decreased energy intake: A post hoc analysis of a randomized placebo-controlled 4.3-year trial

Mattijs Out, Ida Miedema, Harriet Jager-Wittenaar, Cees van der Schans, Wim Krijnen, Philippe Lehert, Coen Stehouwer, Adriaan Kooy*

*Corresponding author for this work

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Metformin prevents weight gain in patients with type 2 diabetes (T2D). However, the mechanisms involved are still unknown. In this post hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850mg metformin or received placebo added to insulin (1-3 times daily) for 4.3years. Dietary intake was assessed at baseline, after 1year and after 4.3years, according to the dietary history method. Among the 310 included participants, 179 (93 placebo, 86 metformin) completed all 3 dietary assessments. We found no significant difference in energy intake after 4.3years between the groups (metformin vs placebo: -31.0kcal/d; 95% CI, -107.4 to 45.4; F-value, 1.3; df=415; P=.27). Body weight in placebo users increased significantly more than in metformin-users during 4.3years (4.9 +/- 4.9 vs 1.1 +/- 5.2kg; t test: P.001). Linear mixed models did not show a significant effect of energy intake as explanation for the difference in weight gain between the groups (F-value, 0.1; df=1; P=.82). In conclusion, the prevention of weight gain by metformin cannot be explained by reduced energy intake.
Original languageEnglish
Pages (from-to)219-223
Number of pages5
JournalDiabetes Obesity & Metabolism
Issue number1
Publication statusPublished - 1 Jan 2018


  • appetite control
  • insulin therapy
  • metformin
  • obesity therapy
  • randomised
  • trial
  • type 2 diabetes

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