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Schommers, P.* ; Thurau, A.* ; Bultmann-Mellin, I.* ; Guschlbauer, M.* ; Klatt, A.R.* ; Rozman, J. ; Klingenspor, M. ; Hrabě de Angelis, M. ; Alber, J.* ; Gründemann, D.* ; Sterner-Kock, A.* ; Wiesner, R.J.*

Metformin causes a futile intestinal-hepatic cycle which increase energy expenditure and slows down development of a type 2 diabetes-like state.

Mol. Metab. 6, 737-747 (2017)

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Objective Metformin, the first line drug for treatment of type 2 diabetes, suppresses hepatic gluconeogenesis and reduces body weight in patients, the latter by an unknown mechanism. Methods Mice on a high fat diet were continuously fed metformin in a therapeutically relevant dose, mimicking a retarded formulation. Results Feeding metformin in pharmacologically relevant doses to mice on a high fat diet normalized HbA1c levels and ameliorated glucose tolerance, as expected, but also considerably slowed down weight gain. This was due to increased energy expenditure, since food intake was unchanged and locomotor activity was even decreased. Metformin caused lactate accumulation in the intestinal wall and in portal venous blood but not in peripheral blood or the liver. Increased conversion of glucose-1-¹³C to glucose-1,6-¹³C under metformin strongly supports a futile cycle of lactic acid production in the intestinal wall, and usage of the produced lactate for gluconeogenesis in liver. Conclusions The reported glucose–lactate–glucose cycle is a highly energy consuming process, explaining the beneficial effects of metformin given continuously on the development of a type 2 diabetic-like state in our mice.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Futile cycle; Splanchnic bed; Metformin; Mitochondria; Respiratory-chain; European Association; Consensus Statement; Glucose-metabolism; Image-analysis; Insulin; Weight; Hyperglycemia; Management; Phosphorylation

ISSN (print) / ISBN 2212-8778

e-ISSN 2212-8778

Journal Molecular Metabolism

Quellenangaben Volume: 6, Issue: 7, Pages: 737-747

Publisher Elsevier

Publishing Place Amsterdam

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Experimental Genetics (IEG)