Effectiveness of Metformin Monotherapy vs. Metformin-Insulin Combination on Glycemic Control for Type 2 Diabetes in Eastern Libya

Type 2 diabetes (T2D) management focuses on achieving optimal glycemic control to mitigate the risk of complications. Metformin monotherapy and metformin-insulin combination therapy are standard treatment approaches. This study aimed to compare the efficacy of metformin monotherapy versus metformin combined with insulin in achieving glycemic control in T2D patients in Eastern Libya. A cross-sectional study was conducted from July 1, 2023, to December 30, 2023, involving 226 participants out of an initial 239, after applying inclusion and exclusion criteria. Eligible participants included T2D patients on metformin monotherapy or combination therapy, aged 18 years and older, with a minimum treatment duration of three months. Exclusion criteria included those on other regimens or newly diagnosed. The final sample consisted of 43.4% males (n=98) and 56.6% females (n=128), with a mean age of 58 years, mean disease duration of 12.9 years, and a mean HbA1c of 7.7%. Of the participants, 91 were on metformin monotherapy, which demonstrated a lower mean HbA1c of 7.1% (±0.93), compared to the 128 participants on metformin-insulin combination therapy, with a mean HbA1c of 8.1% (±1.1). An independent T-test revealed a statistically significant difference (p<0.001). These findings suggest that metformin monotherapy may be more effective in achieving glycemic control in certain T2D patients. Future studies are warranted to validate these results and further investigate potential influencing factors.