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Randomized Controlled Trial
. 2015 May;16(3):196-203.
doi: 10.1111/pedi.12140. Epub 2014 Apr 3.

Effects of low dose metformin in adolescents with type I diabetes mellitus: a randomized, double-blinded placebo-controlled study

Kristen J Nadeau  1 , Kelsey Chow, Suhyla Alam, Kara Lindquist, Sarah Campbell, Kim McFann, Georgeanna Klingensmith, Phillipe Walravens
Affiliations
Randomized Controlled Trial

Effects of low dose metformin in adolescents with type I diabetes mellitus: a randomized, double-blinded placebo-controlled study

Kristen J Nadeau et al. Pediatr Diabetes. 2015 May.

Abstract

Background: Insulin resistance increases during adolescence in those with type 1 diabetes mellitus (T1DM), complicating glycemic control and potentially increasing cardiovascular disease (CVD) risk. Metformin, typically used in type 2 diabetes mellitus (T2DM), is a possible adjunct therapy in T1DM to help improve glycemic control and insulin sensitivity.

Objective: We hypothesized that metformin would improve metabolic parameters in adolescents with T1DM.

Design, setting, and participants: This randomized, double-blinded, placebo-controlled trial included 74 pubertal adolescents (ages: 13-20 yr) with T1DM. Participants were randomized to receive either metformin or placebo for 6 months. Glycated hemoglobin (HbA1c), insulin dose, waist circumference, body mass index (BMI), and blood pressure were measured at baseline, 3 and 6 months, with fasting lipids measured at baseline and 6 months.

Results: Total daily insulin dose, BMI z-score and waist circumference significantly decreased at 3 and 6 months compared to baseline within the metformin group, even among normal-weight participants. In the placebo group, total insulin dose and systolic blood pressure increased significantly at 3 months and total insulin dose increased significantly at 6 months. No significant change was observed in HbA1c at any time point between metformin and placebo groups or within either group.

Conclusions: Low-dose metformin likely improves BMI as well as insulin sensitivity in T1DM adolescents, as indicated by a decrease in total daily insulin dose. The decrease in waist circumference indicates that fat distribution is also likely impacted by metformin in T1DM. Further studies with higher metformin doses and more detailed measurements are needed to confirm these results, their underlying mechanisms, and potential impact on CVD in T1DM youth.

Keywords: adolescents; insulin resistance; metformin; type 1 diabetes mellitus.

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References

    1. Libby P, Nathan DM, Abraham K, et al. Report of the National Heart, Lung, and Blood Institute-National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Cardiovascular Complications of Type 1 Diabetes Mellitus. Circulation. 2005;111(25):3489–3493. - PubMed
    1. Nathan DM, Cleary PA, Backlund JY, et al. Intensive Diabetes Treatment and Cardiovascular Disease in Patients with Type 1 Diabetes. New England Journal of Medicine. 2005;353(25):2643–2653. - PMC - PubMed
    1. Pang TT, Narendran P. Addressing insulin resistance in Type 1 diabetes. Diabet Med. 2008;25(9):1015–1024. - PubMed
    1. Nadeau KJ, Zeitler PS, Bauer TA, et al. Insulin resistance in adolescents with type 2 diabetes is associated with impaired exercise capacity. J Clin Endocrinol Metab. 2009;94(10):3687–3695. - PMC - PubMed
    1. DeFronzo RA, Hendler R, Simonson D. Insulin Resistance is a Prominent Feature of Insulin-dependent Diabetes. Diabetes. 1982;31(9):795–801. - PubMed

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