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Metformin improves peripheral insulin sensitivity in overweight adolescents with T1D

13 Jul 2019

Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.

This double-blind, multicentre, placebo-controlled clinical trial was conducted at eight sites of the T1D Exchange Clinic Network and included a subset of individuals aged 12–19 years with T1D from a larger trial. The inclusion criteria were body mass index ≥85th percentile, HbA1c 7.5–9.9 percent and insulin dosing ≥0.8 U/kg/d.

Participants were randomly assigned to 3 months of metformin (n=19) or placebo (n=18) and underwent a three-phase hyperinsulinaemic euglycaemic clamp with glucose and glycerol isotope tracers to examine tissue-specific IR before and after treatment.

The authors measured peripheral insulin sensitivity, endogenous glucose release and lipolysis rate before and after metformin or placebo therapy.

Differences in change in insulin sensitivity were detected in favour of the metformin vs the placebo arm vis-à-vis whole-body IR (change in glucose infusion rate, 1.3 mg/kg/min, 0.1–2.4; p=0.03) and peripheral IR (change in metabolic clearance rate, 0.923 dL/kg/min, –0.002 to 1.867; p=0.05).

Metformin showed no influence on insulin suppression of endogenous glucose release (p=0.12). In addition, adipose IR could not be measured with traditional methods in this highly IR population.

“T1D in adolescence is characterized by insulin deficiency and IR, both thought to increase cardiovascular disease risk,” the authors said. “We previously demonstrated that adolescents with T1D have adipose, hepatic and muscle IR, and that metformin lowers daily insulin dose, suggesting improved IR.”

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Most Read Articles
29 Nov 2019
Metformin Extended Release 500 mg,750 mg, and 1000 mg
30 Nov 2018
New drug applications approved by US FDA as of 16 - 30 November 2018 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
Elvira Manzano, Roshini Claire Anthony, 01 Oct 2019

The European Society of Cardiology (ESC) has released five new guidelines at the ESC Congress 2019, recommending an even lower LDL-C* target in patients at very high risk for cardiovascular disease (CVD), and the use of SGLT2** inhibitors and GLP-1*** receptor agonists as first-line treatments in those with diabetes to reduce their CVD risk.

Roshini Claire Anthony, 16 Dec 2016

Five years of extended therapy with the aromatase inhibitor (AI) letrozole did not improve survival in postmenopausal breast cancer patients, according to findings of the NRG Oncology/NSABP B-42 trial presented at the San Antonio Breast Cancer Symposium (SABCS 2016) held in Texas, US.