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Review
. 2017 Sep;60(9):1594-1600.
doi: 10.1007/s00125-017-4364-6. Epub 2017 Aug 2.

A new perspective on metformin therapy in type 1 diabetes

Rachel Livingstone  1 , James G Boyle  2   3 , John R Petrie  4 ; REMOVAL Study Team
Affiliations
Review

A new perspective on metformin therapy in type 1 diabetes

Rachel Livingstone et al. Diabetologia. 2017 Sep.

Abstract

Metformin is quite frequently used off-label in type 1 diabetes to limit insulin dose requirement. Guidelines recommend that it can improve glucose control in those who are overweight and obese but evidence in support of this is limited. Recently-published findings from the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial suggest that metformin therapy in type 1 diabetes can reduce atherosclerosis progression, weight and LDL-cholesterol levels. This provides a new perspective on metformin therapy in type 1 diabetes and suggests a potential role for reducing the long-term risk of cardiovascular disease.

Keywords: Atherosclerosis; Cardiovascular; Carotid intima-media thickness; Cholesterol; Metformin; Review; Type 1 diabetes.

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Conflict of interest statement

Funding

The REMOVAL trial was funded by a JDRF Strategic Research Award (17-2011-272). The funder (JDRF) hosted workshops to discuss principles of trial design for adjunctive therapy in type 1 diabetes and to encourage funding applications; however, the funder was not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; or the decision to submit the report for publication.

Duality of interest

RL declares no duality of interest associated with this article. JGB declares no duality of interest associated with this article but reports personal fees from Novo Nordisk, Sanofi Aventis, Boehringer Ingelheim, AstraZeneca and Janssen for advisory boards and educational events/materials. JRP reports research grants from JDRF, during the conduct of the REMOVAL study; personal fees and travel support from Novo Nordisk, research grants and personal fees from Sanofi Aventis, Quintiles and Janssen unrelated to the present work; non-financial support (donation of study medication for the REMOVAL trial) from Merck (Germany); personal fees from Lilly and ACI Clinical unrelated to the present work; and non-financial support from Itamar Medical (donation of equipment and quality assurance support) for the REMOVAL trial.

Contribution statement

RL wrote the first draft of the article; JGB and then JRP revised it critically for important intellectual content; all authors approved the final version to be published.

References

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