Endocrine Abstracts

Introduction
Metformin is being increasingly used in the treatment of Polycystic Ovary Syndrome where it improves the metabolic and reproductive parameters through the improvement of insulin sensitivity. Observations noted that it also tended to prevent weight gain or even facilitate weight loss. Trials carried out have positively enforced this in obese patients as well as those with Polycystic Ovary Syndrome.
We were interested to see if a similar favourable effect could be replicated in a District General Hospital and thus implemented into routine clinical practice.
Method
Patients with Polycystic Ovary Syndrome and/or Obesity (BMI>30) attending the Endocrine clinic were initiated on Metformin 500mg twice daily, and referred to a specialist dietician. They were then followed up four monthly for assessment, during which they were reweighed, and had Metformin dose adjustments. Notes were made of symptom change (Menstruation, hirsutism, acne), side effects, further medication and satisfaction.
Results
Data was successfully collected for 24 patients. Of these 18 had PCOS and 6 were Morbidly Obese. Their average weight at the start was 122 SD 44kg. Average weight at the end was 115 SD40 kg with weight loss being 6 SD12kg. The duration of treatment was on average 15months with the majority having been on for 6 months. 3 patients gained weight and 2 remained static. The average dose used was 2 grams. 9 developed side effects on the Metformin but only 3 needed to discontinue. 11 Females had more regular menstrual cycles but hardly any felt that their hair growth had lessened.
Conclusion
This suggests that Metformin used in aid of weight loss in obese patients or in Polycystic Ovary Syndrome is beneficial. The weight loss improves their self-confidence and renews their determination to persevere. Side effects are possible but the majority tolerate it reasonably well.