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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Metformin, unlike the other major antihyperglycaemic drugs, is not associated with weight gain.

• Ghrelin is an appetite‐stimulating hormone whose concentrations vary in relation to food, obesity and diabetes control.

• Reports are conflicting about how metformin affects ghrelin concentrations, and this study was aimed at resolving this issue in patients with Type 2 diabetes.

WHAT THIS STUDY ADDS

• In this study an increase in ghrelin concentrations was seen in response to metformin treatment in patients with Type 2 diabetes.

• This effect was opposite to what might be expected if the effect of metformin on weight control was mediated via suppression of ghrelin.

• It is likely that the ghrelin response was secondary to improved glycaemic control.

• Meal time changes in appetite and satiety did not correlate with changes in ghrelin, which suggests …