THE ROLE OF METFORMIN IN CENTRAL AND PERIPHERAL NERVE REGENERATION

Abstract

The article presents data on the prevention and treatment of complications such as cognitive impairment and diabetic peripheral neuropathy (DPN) in patients with newly diagnosed type 2 diabetes mellitus.

The aim of the study was to determine the frequency of diabetic peripheral neuropathy and cognitive impairment in patients with newly diagnosed type 2 diabetes and to evaluate the effect of metformin on central and peripheral nerve regeneration by determining the mRNA level of the SLC2A1 transporter gene and the BDNF gene.

Materials and methods. The study included 38 patients with newly diagnosed type 2 diabetes (40 women and 17 men) and 10 controls. All patients received metformin (Glucophage XR or Diaformin SR) as glucose-lowering therapy. The average age of patients was 59.76±1.67 years, BMI – 34.27±0.97 kg/m², HbA1c – 8.12 ± 0.22%. Before the start of the study and after 3 months, the presence of neuropathy, the state of cognitive functions, the mRNA level of the SLC2A1 transporter gene and the BDNF gene were measured.

Results. Patients with newly diagnosed type 2 diabetes had significantly higher BMI, fasting blood glucose and glycated hemoglobin levels, and lower levels of BDNF and SLC2A1 compared to the control group. During the examination of the state of cognitive functions, it was determined that memory impairment was found in 26.3% of patients, speed of information processing - in 97.4%, and executive abilities - in 57.9% of the examined persons. According to the Toronto scale, the presence of peripheral diabetic neuropathy was detected in 68.5% of patients. After a 3-month course of treatment with metformin, the memory status of the patients normalized and the percentage of people without DPN doubled. This positive effect may be a consequence of an increase in the modulator of axon regeneration, in particular BDNF, and a probable increase in SLC2A1, which is a key regulator of glucose transport into the brain through the blood-brain barrier.

Conclusion. Metformin statistically significantly improved the function of memory, executive abilities and reduced the manifestations of peripheral neuropathy, and also increased the level of BDNF and SLC2A1 3 months after the start of treatment in people with newly diagnosed type 2 diabetes, which will further ensure communication with the doctor, high compliance in treatment and will reduce the risk of developing diabetic foot syndrome in the future.