Gender and Therapy Influence the Role of Metformin in Manage Type 2 Diabetes: The Role of OCT2

Abstract

Background: Response to metformin varies among T2DM patients. The influence of gender, therapy type, and renal excretion the organic cation transporter 2 (OCT2) remains incompletely understood.

Objectives: To evaluate the impact of gender and type anti-diabetic therapy metformin efficacy, while also investigate the role of organic cation transporter (OCT2) in renal excretion and clinical outcomes.
Methods: A total of 60 T2DM case and 26 healthy individuals matched for age and sex (aged 30-65 years). After 8-12 hours of fasting, Biochemical and Hormonal analyses were carried out on blood sample, assessing HbA1c, insulin, C-peptide, glucagon, and OCT2 concentrations using ELISA and HPLC techniques. Statistical testing was performed using independent t-test and ANOVA, applying a significant threshold of p< 0. 05.    
Results : Combination therapy with metformin and other anti-diabetic drugs did not provide additional glycemic benefit compared with metformin monotherapy. In the majority of parameters, no significant different for most parameters, except for higher glucagon levels in female patients. Finding support a mechanistic contribution of OCT2 variability to differences in metformin response.

Conclusions: In this cohort, combination therapy did not improve glycemic outcomes beyond metformin monotherapy, emphasizing the need for personalized treatment. Consideration of gender and OCT2-related variability may optimize therapeutic decisions and improve long-term outcomes.