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PCK1 and SLC22A2 gene variants associated with response to metformin treatment in type 2 diabetes

St-Amour S, Tessier L, Harnois J, Allard C, Lavoie A, Caron P, Bouchard L, Perron P et al.

PloS one, 2025

108 participants

Abstract

Type 2 diabetes (T2D) is a chronic disorder affecting 462 million worldwide, often managed with metformin as first-line treatment. However, metformin's response varies among individuals, including up to 30% experiencing serious adverse drug reactions (ADRs) and 20-50% inefficacy. These differences may be due to various factors, including pharmacogenetic (PGx) variants. The PGx variants documented so far could affect both the safety and efficacy of metformin, but due to a lack of replication studies, none reached the clinical evidence-level needed to be used as a predictive marker for treatment response. Therefore, this study aims to evaluate the association between the presence of candidate PGx variants and metformin response in T2D subjects. We conducted an association study involving 108 T2D participants currently or previously treated with metformin. A characterization of their therapeutic response was carried out through questionnaires and pharmacological profile reviews. DNA samples were collected during their single visit to perform genotyping of 24 selected candidate PGx variants. Association analyses between candidate PGx variants and metformin response were performed. Among the subjects included in the analyses (n = 84), 25% were non-responders, and 58% experienced ADRs. At the time of study enrollment, 93.9% of non-responders continued to use metformin. The odds of being a non-responder to metformin are 5.6 times higher for homozygous carriers of the alternative…

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