Novel Assay of Metformin Levels in Patients With Type 2 Diabetes and Varying Levels of Renal Function
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OBJECTIVE: To study trough levels of metformin in serum and its intra-individual variation in patients using a newly developed assay. RESEARCH DESIGN AND METHODS: Trough serum levels of metformin were measured once using liquid chromatography–tandem mass spectrometry (LCMSMS) in 137 type 2 diabetic patients with varying renal function (99 men) and followed repeatedly during 2 months in 20 patients (16 men) with estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 body surface. RESULTS: Patients with eGFR >60, 30–60, and <30 ml/min/1.73 m2 had median trough metformin concentrations of 4.5 μmol/l (range 0.1–20.7, n = 107), 7.71 μmol/l (0.12–15.15, n = 21), and 8.88 μmol/l (5.99–18.60, n = 9), respectively. The median intra-individual overall coefficient of variation was 29.4% (range 9.8–74.2). CONCLUSIONS: Determination of serum metformin with the LCMSMS technique is useful in patients on metformin treatment. Few patients had values >20 μmol/l. Metformin measurement is less suitable for dose titration.
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Above 30 ml/min/1.73 m2, metformin levels rarely go above 20 mmol/l, which seems to be a safe level.
“Frid et al. supports these recommendations through findings that above 30 ml/min/1.73 m2 metformin levels rarely goes above 20 mmol/l, which seems to be a safe level [163].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [163]
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- Authors
- Frid, A., Sterner, G. N., Löndahl, M., Wiklander, C., Cato, A., Vinge, E., & Andersson, A.
- Affiliations
- Department of Endocrinology, University Hospital MAS, Malmö, Sweden;
- Department of Nephrology and Transplantation, Malmö University Hospital, Malmö, Sweden;
- Skåne University Hospital (SE)
- Corresponding author
- Frid, Anders
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2010-03-09
- Volume
- 33
- Issue
- 6
- Pages
- 1291-1293
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2875440
- OpenAlex
- W2130429000
- Cited by
- 126
- References
- 8
- Citations by year
- 2025: 1 · 2024: 11 · 2023: 4 · 2022: 7 · 2021: 9 · 2020: 8 · 2019: 9 · 2018: 11 · 2017: 11 · 2016: 12 · 2015: 9 · 2014: 9 · 2013: 9 · 2012: 10
- FWCI
- 6.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Physical Sciences › Chemistry › Analytical Chemistry › Analytical Methods in Pharmaceuticals
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Keywords
- metformin, type 2 diabetes, renal function, estimated glomerular filtration rate, liquid chromatography-tandem mass spectrometry, within-person variability, dose titration, pharmacokinetics
- MeSH terms
- Adult, Aged, Aged, 80 and over, Biological Assay, Chromatography, High Pressure Liquid, Diabetes Mellitus, Type 2, Female, Glomerular Filtration Rate, Humans, Hypoglycemic Agents, Kidney Function Tests, Male, Metformin, Middle Aged, Mass Spectrometry
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