Teens With Type 1 Diabetes Benefit
From Metformin
Metformin as adjunctive therapy for adolescents
with type 1 diabetes and insulin resistance lowered
hemoglobin A1c levels and decreased insulin dosage
with no weight gain.
“This improvement may have been attributable
to the direct impact of metformin on peripheral
tissues, but more likely was secondary to metformin's
effects on decreased hepatic glucose output, or,
possibly, as a consequence of weight loss subsequent
to a decreased appetite,” they said
In this small randomized, placebo-controlled
study, 27 children aged 12-17 years who attended
the diabetes clinic at the hospital were recruited.
Patients had suboptimal metabolic control, which
was defined as a hemoglobin A1c (HbA1c) level
greater than 8% but less than 11% for the prior
6 months, and insulin dosage of 1 U/kg per day
or greater. Of the 27 patients, 14 received metformin
and 13 received placebo, and all were monitored
over a 3-month period.
The metformin dose was started at 500 mg/day
at breakfast and was increased by 500 mg/day each
week to a maximum of 1,000 mg/day for children
who weighed less than 50 kg, 1,500 mg/day for
children who weighed 50-75 kg, and 2,000 mg/day
for those who weighed more than 75 kg.
At the end of the study, children who took metformin
had significantly lower HbA1c levels (0.6% lower)
and daily insulin dosages (an average of 0.12
U/kg per day lower), compared with those on placebo.
There was no significant change in body mass index
between the two groups. Diabetes Care 26[1]:138-43,
2003.
