Glycemic and metabolic changes with Metformin Monotherapy in Newly Diagnosed Type 2 Diabetes Mellitus Patients

Mohamed, Asmaa S.; Refaei, Hosam M. A.; Kamel, Fatma M.M.

doi:10.21608/rpbs.2025.407306.1389

Glycemic and metabolic changes with Metformin Monotherapy in Newly Diagnosed Type 2 Diabetes Mellitus Patients

Document Type : Original Article

Authors

¹ Clinical Pharmacy and pharmacy practice department, Faculty of Pharmacy, Port said University, Port said, Egypt.

² Internal Medicine and Biochemistry departments, Egypt Ministry of Health and Population. Directorate of Health Affairs, Minia, Egypt.

³ Internal Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt.

10.21608/rpbs.2025.407306.1389

Abstract

Background Metformin is the first-line pharmacologic treatment for type 2 diabetes mellitus (T2DM), yet patient response can vary. Identifying clinical predictors of early glycemic response may help personalize therapy. The main objective of this study is to evaluate baseline predictors of glycemic response to metformin monotherapy in newly diagnosed patients with T2DM.
Methods A prospective cohort study was conducted at Minia University Hospital involving 220 newly diagnosed T2DM patients. Participants initiated metformin monotherapy (500–2000 mg/day) and were followed for 3 months. Glycemic response was defined as achieving HbA1c < 7% at follow-up. Clinical, demographic, and laboratory data were collected at baseline and reassessed after 3 months. Logistic regression was used to identify independent predictors of treatment success.
Results After 3 months, 65.5% of patients achieved HbA1c < 7%, with a significant mean reduction in HbA1c from 7.39% to 6.5% (p < 0.001). Body mass index (BMI) also decreased significantly (24.32 to 22.33 kg/m², p < 0.001). Younger age, lower BMI, and lower baseline HbA1c were significantly associated with better glycemic response (p < 0.001). However, in multivariable analysis, only baseline HbA1c remained a significant independent predictor (OR 0.12, 95% CI 0.05–0.30, p < 0.001).
Conclusion Lower baseline HbA1c is a strong predictor of short-term glycemic response to metformin monotherapy in newly diagnosed T2DM patients. These findings support early intervention and individualized treatment strategies to optimize outcomes.

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