A Pilot Study of the Effect of NM-504 Cobiotic Formulation on the Efficacy and Tolerability of Metformin in Patients With Metformin Intolerance

Only subjects with known intolerance to metformin will be recruited and enrolled in this study. When a participant qualifies, after signing the consent, they will be asked to complete a questionnaire about medical history which will be reviewed with the coordinator. Their height, weight, and blood pressure will be measured, and their medications will be reviewed. They will be taught how to measure their fasting blood glucose by a finger stick. They will be given metformin and asked to take a 500mg tablet twice day before breakfast and dinner starting the next day with breakfast. They will be given doses of NM504 or a placebo in a pouch to be mixed with 6 ounces of water before breakfast and dinner as a smoothie drink starting before breakfast the next day. Before consuming the first smoothie each day and before eating any food each day they will be asked to record their fasting finger stick blood glucose and complete the questionnaire about their bowel habits. The study takes place in two-week segments with a two week washout in between. They will receive metformin in both periods, but they will receive NM504 during one 2-week segment and a placebo smoothie during the other two-week segment. Five subjects will receive NM504 and 5 subjects will be assigned placebo during the initial 2 weeks. The treatment sequence will be randomly assigned. After the 2 week washout period the subjects will cross over to either placebo or NM504.

Phone Visit 1: week 1 subjects will receive a call from the coordinator to see how they are tolerating the metformin and the smoothies. An increase in metformin dose to 500mg 3 times a day may or may not happen.

Clinic Visit 2: week 2, Subjects will bring bottle of metformin and empty packages of smoothie powder to the visit along with logs of their daily fasting finger stick blood glucose and their daily bowel questionnaires. Their body weight weight will be measured.

Clinic Visit 3: week 4, subjects will be asked about their metformin tolerance and body weight will be measured. They will be given metformin and asked to take a 500 mg pill twice a day before breakfast and dinner starting the next day before breakfast. Before consuming the first smoothie each day, and before eating any food each day, subjects will be asked to record a fasting finger stick blood glucose and complete the questionnaire about bowel habits.

Phone Visit 2: week 5 subjects will be asked about their tolerance to metformin and the smoothies. They may or may not be asked to increase their 500mg dose of metformin from 2 times a day to 3 times a day.