People respond differently to drugs. Some individuals, for instance, experience improvement in health much faster than others who take the same medication and it appears that this holds true even with the diabetes drug Metformin.

Metformin is often prescribed as a first-line treatment for type 2 diabetes patients but the clinical trials from which the drug's standard of care was based on were made up mostly of white participants, said Keoki Williams, from the Henry Ford Health System (HFHS) in Michigan.

Because little is known about the effects of the drug in African American diabetic patients, Williams and his colleagues conducted a study to assess the efficacy of metformin on the black population and to determine if the effect of metformin varies by race-ethnicity.

For their study published in the Journal of Clinical Endocrinology & Metabolism (JCEM) on June 12, the researchers looked at the pharmacy and medical records of more than 7,400 African American and over 8,700 white diabetic patients who took metformin to examine the participants' exposure to the medication and other diabetes drugs. The participant of the study also had a minimum of two fills of metformin and had their hemoglobin A1c, or HbA1c, blood sugar level measured at least twice with four months interval.

By measuring the participants' blood sugar levels relative to the amount of metformin that they have taken, the researchers observed that the maximum dose of the drug is linked with a 0.9 percent reduction in HbA1c levels in African American participants while the same dose results in a 0.42 percent drop in HbA1c levels in white participants suggesting that the effects of metformin on individuals vary by race and that blacks respond more positively to metformin than whites.

"African American individuals appear to have a better glycemic response to metformin when compared with European Americans," the researchers wrote. "Further studies are needed to determine whether this translates to commensurate reductions in diabetes complications."

African-Americans are twice as likely as white to develop type 2 diabetes. They are also more at risk of diabetes-related complications. Williams said that that the results of their study is encouraging in that metformin appears to be better at controlling blood sugar in individuals who appear to be more vulnerable to the disease.

"Moreover, since African Americans are more likely to suffer from diabetic complications when compared with white individuals, it is heartening to observe that metformin is likely more effective at controlling blood glucose in the former group," Williams said.

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