To print: Select File and then Print from your browser's menu

Title: Metformin May Improve Metabolic Control in Adolescents with Type I Diabetes

URL: http://www.eje.org/eje/149/eje1490323.htm

Eur J Endocrinol 2003 Oct;149:4:323-9. "Metformin as additional therapy in adolescents with poorly controlled Type 1 diabetes. Randomised placebo-controlled trial with aspects on insulin sensitivity"
11/21/2003 02:38:00 PM
By Keely S. Solomon, PhD

Metformin therapy may improve metabolic control in adolescents with poorly controlled type I diabetes, according to new research. Children with type I diabetes frequently experience a substantial decrease in insulin sensitivity during puberty, which often leads to a decline in metabolic control despite increased insulin dosages. "Thus, there is a great need for alternative therapeutic strategies in adolescents with type I diabetes," writes Stefan Sarnblad of the University Hospital, Orebro, Sweden. Dr. Sarnblad and colleagues performed a study to determine whether the addition of metformin therapy could improve glycaemic control and insulin sensitivity in adolescents with poorly controlled type I diabetes. Twenty-six adolescents (mean age, 16.9 ą 1.6 years; 18 females) were randomised to receive either oral metformin or placebo for 3 months. Participants receiving metformin started with 500 mg daily for 1 week, followed by 500 mg twice daily for 3 weeks, and then 1000 mg twice daily for the rest of the study. Mean glycated haemoglobin significantly decreased in the metformin group during the study period (9.6% to 8.7%; [P < .05), but remained unchanged in the placebo group (9.5% vs. 9.2%; ns). Participants receiving metformin also experienced a significant increase in peripheral insulin sensitivity (P < .05), which was estimated by euglycaemic hyperinsulinaemic clamp. In addition, the researcher noted that patients with a higher level of insulin-resistance showed greater improvements in both glycated haemoglobin and peripheral insulin sensitivity. They suggest that, "the main effect of metformin in adolescents with type I diabetes is associated with improved peripheral insulin sensitivity." This mechanism is in contrast to patients with type 2 diabetes, where the effect is predominately mediated by a decrease in hepatic glucose output. No changes in weight or blood lipid levels occurred for either group, and no serious adverse effects were detected. Although previous studies have reported a reduced need for insulin in type I diabetes patients receiving metformin, a similar effect was not observed in the present study. "Adjunctive therapy with metformin in adolescents with type I diabetes is efficacious and safe, " the researchers conclude. However, they add that "further, larger studies carried out over longer time periods, are recommended."

http://www.eje.org/eje/149/eje1490323.htm

Copyright Š 2009 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content.