Accepted for publication 17 February 2017 Published Volume 20 Pages 1481—1488 DOI https://doi.org/10.2147/DDDT. S131670 Checked for plagiarism Yes Review by Single-blind Peer reviewers approved by Dr Rasika Samarasinghe Peer reviewer comments 2 Editor who approved publication: Professor Manfred Ogris Ph D School in Experimental Medicine, University of Pavia, Pavia, Italy Purpose: The purpose of this study is to evaluate, in a randomized clinical trial, the effects of metformin immediate release (IR) compared with metformin extended release (XR) on the gastrointestinal tolerability and glycemic control. Materials and methods: We enrolled 253 Caucasian patients with type 2 diabetes not well controlled by diet (glycated hemoglobin [Hb A, fasting and postprandial glucose, fasting plasma insulin (FPI) and homeostasis model assessment insulin resistance (HOMA-IR), lipid profile, and levels of some adipocytokines, including tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), visfatin, and vaspin. Moreover, at the baseline and after 6 months, we administered patients some validated questionnaires to assess patients’ satisfaction toward treatments. Results: After 6 months, both formulations gave a similar reduction in body weight and body mass index (BMI); however, metformin XR gave a greater improvement in glycemic control, FPI, and HOMA-IR, compared with both baseline and metformin IR. A reduction in total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol was observed with metformin XR compared with IR. Levels of TNF-α, hs-CRP, and vaspin were reduced by metformin XR but not by the IR formulation. Conclusion: Metformin XR formulation seems to be more effective than metformin IR in improving glyco-metabolic control, lipid profile, and levels of some adipocytokines in patients with type 2 diabetes mellitus. Synjardy XR, a joint development of Boehringer Ingelheim Pharmaceuticals and Eli Lilly and Company, combines empagliflozin (brand name Jardiance), an SGLT2 inhibitor, and metformin extended-release (brand name Glucophage XR and others). Food and Drug Administration (FDA) has approved the combination oral diabetes medicine Synjardy XR for use, along with a healthful diet and exercise, in adults with Type 2 diabetes. In the process of filtering the blood, the kidneys typically reabsorb all the filtered glucose and return it to the bloodstream. One of the main proteins responsible for this reabsorption is SGLT2. By inhibiting the action of SGLT2, empagliflozin blocks the reabsorption of glucose by the kidneys, promoting a loss of glucose in the urine and lowering blood glucose levels. Metformin works by decreasing the amount of glucose made by the liver and by improving insulin sensitivity in the liver, muscle, and fat cells. Synjardy XR tablets will be offered in doses of 5 milligrams of empagliflozin/1,000 milligrams of metformin extended-release, 10 milligrams of empagliflozin/1,000 milligrams of metformin extended-release, 12.5 milligrams of empagliflozin/1,000 milligrams of metformin extended-release, and 25 milligrams of empagliflozin/1,000 milligrams of metformin extended-release, to be taken once daily with the morning meal.
It comes as an oral tablet and an oral solution. Metformin oral tablet comes in two forms immediate-release and extended-release. The immediate-release tablet. Effects of metformin extended release compared to immediate release formula on glycemic control and glycemic variability in patients with type.