Metformin ineffective in obese teens on long-term basis, study suggests

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Obese adolescents who are treated with metformin may experience initial benefits but not over the long-term, research shows. Metformin is a first-line drug treatment for type 2 diabetes, helping to lower blood sugar levels. The drug has also been associated with short-term weight loss in young people in other trials. A team from the St Antonius Hospital in Nieuwegein, the Netherlands, wanted to explore the subject further. They prescribed 31 adolescents metformin, of which 84% were obese and 45% had developed insulin resistance. The team also studied a further 20 teenagers who were not given the drug. The findings showed the participants who were given metformin initially improved their body mass index (BMI) and insulin resistance, but after three years the changes had not remained. The researchers concluded that there is "no evidence for sustained effect after prolonged use in adolescents". Yvette Lentferink, from the hospital's department of paediatrics, said: "Studies on the efficacy of metformin in adolescents are predominantly limited to a follow-up period of 6 months. "Only a few studies have been performed with a longer follow-up period with a maximum up to 24 months. Consequently, it is unclear whether prolonged metformin treatment in adolescents will result in long-lasting positive effects on weight." The study team added that the findings contradict studies in non-diabetic adults where metformin led to sustained weight loss. They explained this could be due to limited compliance and/or insufficient dose. The results appear online in the journal Nature. In adults with type 2 diabetes, research is showing that eating a healthy, real-food diet can put the condition into remission, meaning people can be free from diabetes medication. Visit our Low Carb Program for further details.

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ickihun

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Because it has to be taken continuously everyday for it to work.
What teen do you know takes a tablet/multivitamin, for example, religiously everyday? None I know.

Metformin tolerant people need metformin like the 'pill' . An under the skin longterm drug. However if not as cheap as the tablet what chance has anyone got?
I think many young girls pay for the 'pill/insert'. Inserted for free but have to pay for the drug. I think.
The 'pill' has always been quite cheap but not as cheap as Metformin though.

Longterm continuous use of metformin reaps huge rewards.

Not able to tolerate metformin currently I'm seeing huge changes which aren't positive. Hard tummy and weight gain. More insulin resistant. Lately I'm looking pregnant with high levels of prolactin and my blood tests came back that I'm not going through the change but have all the symptoms. Especially hot flushes. No sign of PCOS in blood tests now so decades on metformin may have 'cured' it, for me. Although hirsutism is needing more attention without metformin especially on my face. My short hairs are thicker and stronger. No regular periods either.

I've started a 800cals diet but awoke with constipation so fibrogel is now my best friend. Ha ha
Yesterday I was soooo hungry as milk shakes have sugar in them. Mebeverine too so still on high insulin but just less of it.
Metformin halves my insulin need. So for me I benefit more than just the 2mmol/l less glucose in my blood, I get fat far more than that on continuous metformin use. (2 healthy babies in an infertile time in my life too).
 

bulkbiker

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Strange if CICO worked then all that running backwards and forwards to the loo would have made then stick thin surely...
 

fatismyfriend

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Have you tried the low carb programme? If so how did that affect you? It’s supposed to be an alternative to metformin...
 

ickihun

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Have you tried the low carb programme? If so how did that affect you? It’s supposed to be an alternative to metformin...
I do low carb. Have done for over a year now.
I can see cheese and nuts being a weight adder so if any of your patients cannot lose, they need to lose them. Water is best too, rather than any other drinks.
On the 800cals diet it has stopped dairy except milk for shakes. Far less protein too but only a small weight loss for me but still a loss. Only started 800cals on 19th Sep'18 (dated so I can refer back to it if need be). A very tough regime. I can taste the gritty sugar. I'm not sure Soy protein works with my underactive thyroid? In the 80s my meal replacements by Weider FIRMALOSS sold by Argos had me losing 7st+ but I was younger and not sure if Soy/a was used as cannot obtain an old nutrition label. These from Superdrug or Tesco are soy based.

A short period on 800cals which are less carbs than most undiagnosed type2s are on may frighten some.
Ive had to adapt to it by feeding the sickly hunger on day one but far less sickly today. However I've just started Dapagliflozin to help lose that essential 3kgs off for my op. So not sure if sickly feeling off new tablet or effects on thyroid, blood pressure/fast heart beat but have a cold so my body has reacted to less nutrients. I feel very vunerable and was crying on day one due to hormones.
Relieved my endo could think of something for me. I was at the end of my tether as insulin need was rising. Not reducing, like I prefer.
 
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ickihun

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For me, low carb is great at lower bgs and an excellent aid to reduce high bgs but because I'm on insulin I also find if too much protein the protein replaces carbs for glucose conversion.
Injected insulin doesn't like too much fat and can slow down digestion to a point of me suffering with GERD and now IBS. LCHF diet gives satiety but it causes me more problems.
The low carb element of eating is very very tough for over-eaters but a great compliment to diabetes management.

Liver blocks (eating fatty protein) are the substitutes to Metformin not low carb eating.
Dawn phenomenon does exist but in various times of the day not just at dawn. Shift workers beware!
Anytime the body thinks your being starved it dumps glucose to keep you alive. Everyone, even none diabetics.

For me this is a few times a day.

I've always argued my diabetes is about my liver, not pancreas. But those who have researched type2 says no. Its about the fat cells; everywhere in the body.
 

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This study (although small) saddens me. It tells me that diagnoses is coming younger and younger and that one may not necessarily have had to have been insulin resistant very long before T2 raises its ugly head.
 

ickihun

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This study (although small) saddens me. It tells me that diagnoses is coming younger and younger and that one may not necessarily have had to have been insulin resistant very long before T2 raises its ugly head.
I agree. Also they are only being tested due to being overweight. Many are in good habits so aren't overweight, hence not tested. But they are diabetic but in 'remission'.
Yes IR would be better measured rather than its symptoms.