OPTIMIZATION OF METFORMIN DISCONTINUATION IN DIABETIC PATIENTS EXPLORED WITH 18F-FDG PET/CT

Transcripción

1 OPTIMIZATION OF METFORMIN DISCONTINUATION IN DIABETIC PATIENTS EXPLORED WITH 18F-FDG PET/CT P.717 B. Pérez-Pevida1, L. Sancho Rodriguez2, E.F. Guillén Valderrama2, F.J. Escalada San Martín1, M.J. García Velloso2, E. Pascual Corrales1, G. Gutiérrez Buey1, M. Llavero Valero1, J.C. Galofré Ferrater1, J.A. Richter2, J. Salvador Rodríguez1. 1Endocrinology and Nutrition, 2Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain. BACKGROUND AND AIMS It is known that metformin (M) increases 18F-FDG PET/CT intestinal uptake and that it is reduced after its discontinuation for 3 days. The aim of this study was to determine if in patients with type 2 diabetes mellitus (T2D), 24 or 48 h metformin discontinuation could be useful to reduce 18F-FDG PET/CT intestinal uptake keeping patient s glucose levels (GL) in normal range and improving PET/CT quality. MATERIAL AND METHODS T2D PATIENTS TREATED WITH ANTIDIABETIC DRUGS (AD) (n=101) GROUP A (n=81) (M: no discontinuation) GROUP A1 (n=31) (Treatment with M) GROUP B (n=20) (OTHER AD) GROUP A2 (n=21) (M discontinuation 24h before 18F-FDG PET/CT) GROUP C (n=30) (CONTROL GROUP) GROUP A3 (n=29) (M discontinuation 48h before 18F-FDG PET/CT) RESULTS INTESTINAL 18F-FDG UPTAKE WAS ASSESSED: Qualitatively (normal, mild, moderate or intense) Semi-quantitatively A B C (SUVmax, SUVmean, SUVpeak and TBR) D INTESTINAL UPTAKE A) Normal B) Mild C) Moderate D) Intense Characteristics and FDG uptake values of the study population A1 A2 A3 METFORMIN DISCONTINUATION BEFORE PET/CT A1) NO DISCONTINUATION A2) 24h A3) 48h GROUP A1 A2 A3 B C ANOVA Sig. (p-valor) AGE 68.6± ±8.5 68,5±12,9 73.7± ± BMI 29.2± ± ± ± ± GLUCOSE 122± ± ± ±19 95±11 < 0.01 TBR * < 0.01 SUV max 6.9± ± ± ± ±2.2 < 0.01 Intense Intestinal Uptake % (Chi Square) < 0.01 CONCLUSIONS Metformin discontinuation for 48h is feasible and better than 24h for reducing intestinal 18F-FDG uptake in T2D and it significantly improves PET/CT studies quality Although glucose levels increased with discontinuation, they were in normal range according to the guidelines bppevida@ unav.es à Clínica Universidad de Navarra, Pamplona 51st Annual Meeting EASD, Stockholm 2015