Meds, Mind, Body & Benefits > Lipodystrophy & Metabolic Problems



Greetings, Everyone!  I have Crix Belly (visceral fat).  Does METFORMIN decrease visceral fat and decrease blood glucose, insulin and lipid levels?  If so, any adverse effects?  Thanks much.

You should check with your doctor immediately if any of these side effects occur when taking metformin:

More common:

Abdominal or stomach discomfort
cough or hoarseness
decreased appetite
fast or shallow breathing
fever or chills
general feeling of discomfort
lower back or side pain
muscle pain or cramping
painful or difficult urination

I take 1000 mg (one pill) of metformin at dinner time
(because it is eliminated through kidneys, so I like to keep it 12hours apart from that Complera pill)

Effects of lifestyle modification and metformin on atherosclerotic indices among HIV-infected patients with the metabolic syndrome.

--- Quote ---Among the participants, duration of HIV-infection was 14 1 year and duration of antiretroviral therapy was 6 1 year. Metformin-treated patients demonstrated significantly less progression of CAC (-1 2 vs. 33 17, P = 0.004, metformin vs. placebo), whereas the effect of LSM on CAC progression was not significant (8 6 vs. 21 14, P =  0.82, LSM vs. no-LSM). Metformin had a significantly greater effect on CAC than LSM (P = 0.01). Metformin-treated patients also demonstrated less progression in calcified plaque volume (-0.4 1.9 vs. 27.6 13.8 μl, P = 0.008) and improved homeostatic model of assessment-insulin resistance (HOMA-IR) (P = 0.05) compared with placebo. Participants randomized to LSM vs. no-LSM showed significant improvement in HDL (P = 0.03), high-sensitivity C-reactive protein (hsCRP) (P = 0.05), and cardiorespiratory fitness. Changes in CAC among the four groups--no-LSM-placebo (43 30); LSM-placebo (19 7); no-LSM-metformin (1 1) and LSM-metformin (-4 6)--were different (P = 0.03 for ANOVA and linear trend across groups), and the majority of this effect was mediated by metformin. Results are mean SEM.
CONCLUSION: Metformin prevents plaque progression in HIV-infected patients with the metabolic syndrome.
--- End quote ---

The efficacy and safety of insulin-sensitizing drugs in HIV-associated lipodystrophy syndrome: a meta-analysis of randomized trials.

--- Quote ---BACKGROUND:

HIV-associated lipodystrophy syndrome (HALS) is characterized by insulin resistance, abnormal lipid metabolism and redistribution of body fat. To date, there has been no quantitative summary of the effects of insulin sensitizing-agents for the treatment of this challenging problem.

We searched MEDLINE, the Cochrane Library, clinical trial registries, conference proceedings and references for randomized trials evaluating rosiglitazone, pioglitazone or metformin in patients with evidence of HALS (last update December 2009). Two reviewers independently abstracted data and assessed quality using a standard form. We contacted authors for missing data and calculated weighted mean differences (WMD) and 95% confidence intervals (CI) for each outcome.

Sixteen trials involving 920 patients met inclusion criteria. Rosiglitazone modestly improved fasting insulin (WMD -3.67 mU/L; CI -7.03, -0.31) but worsened triglycerides (WMD 32.5 mg/dL; CI 1.93, 63.1), LDL (WMD 11.33 mg/dL; CI 1.85, 20.82) and HDL (WMD -2.91 mg/dL; CI -4.56, -1.26) when compared to placebo or no treatment in seven trials. Conversely, pioglitazone had no impact on fasting insulin, triglycerides or LDL but improved HDL (WMD 7.60 mg/dL; CI 0.20, 15.0) when compared to placebo in two trials. Neither drug favorably impacted measures of fat redistribution. Based on six trials with placebo or no treatment controls, metformin reduced fasting insulin (WMD -8.94 mU/L; CI -13.0, -4.90), triglycerides (WMD -42.87 mg/dL; CI -73.3, -12.5), body mass index (WMD -0.70 kg/m2; CI -1.09, -0.31) and waist-to-hip ratio (WMD -0.02; CI -0.03, 0.00). Three trials directly compared metformin to rosiglitazone. While effects on insulin were comparable, lipid levels and measures of fat redistribution all favored metformin. Severe adverse events were uncommon in all 16 trials.

Based on our meta-analysis, rosiglitazone should not be used in HALS. While pioglitazone may be safer, any benefits appear small. Metformin was the only insulin-sensitizer to demonstrate beneficial effects on all three components of HALS.
--- End quote ---

I just started Metformin today. 500mg once a day to start. Doctor wants to see how I tolerate it. I will go for labs in 30 days. I have Crix belly and am tired of it. My T-cells were single digit in the fall of 1996 so I am grateful that Crixivan was around then or I wouldn't be alive. I have been cutting back on carbs but that hasn't worked but I hope the Metformin kicks starts some belly reduction. Wish me luck.


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