Metformin Added to Insulin in Pediatric Type 1 Patients

Metformin is safe and may represent a useful adjunct to the management of type 1 diabetes mellitus in adolescents and young adults.

The aim of this study was to evaluate the effect of metformin in addition to insulin therapy in adolescents and young adults with type 1 diabetes mellitus.

Nine patients, two males and seven females, aged 18.1 +/- 3.0 years, with type 1 diabetes mellitus were studied. They were relatively overweight with a body mass index (BMI) of 24.2 and had high levels of HbA1c at 9.5 despite high doses of insulin of 74.0 U/day.

Metformin at the dose of 500-750 mg daily was administered to the patients in addition to insulin therapy for 1 year.

HbA1c, BMI and insulin dose were compared before 1 year without metformin therapy, at baseline, and at 3, 6 and 12 months during the use of metformin in addition to insulin therapy. HbA1c lowered (8.6 +/- 1.4**, 8.4 +/- 1.3**, 8.4 +/- 1.2*%), BMI was reduced (23.9 +/- 1.7*, 23.8 +/- 1.8, 23.5 +/- 1.8*), and insulin requirement decreased (69.8 +/- 29.7*, 68.7 +/- 29.8**, 67.3 +/- 29.1**U/d) significantly after the start of metformin therapy. There were no adverse events, not even lactic acidosis, during the study period.

Conclusion: Metformin is safe and may represent a useful adjunct to the management of type 1 diabetes mellitus in adolescents and young adults who have poor glycemic control despite a large amount of insulin. Pediatr Int. 2005 Aug;47(4):430-3.

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