Metformin does not improve glycemic control in overweight teens with type 1 diabetes, research finds

Jack Woodfield
Mon, 07 Dec 2015
Metformin does not improve glycemic control in overweight teens with type 1 diabetes, research finds
Giving metformin alongside insulin to overweight adolescents with type 1 diabetes does not improve blood glucose control, a new study finds.

This new research, supported by the Juvenile Diabetes Research Federation (JDRF), aimed to assess the efficacy and safety of metformin - a commonly used drug to treat type 2 diabetes - in treating overweight adolescents with type 1 diabetes alongside insulin.

According to Dr. Sanjoy Dutta, PhD, JDRF, glucose management is at its worst among obese and overweight adolescents with type 1 diabetes. This can necessitate higher doses of insulin, which can lead to further weight gain.

The study took place at 26 pediatric clinics in the United States T1D Exchange Clinical Network between October 2013 and February 2014. 140 participants with a baseline HbA1c of 8.8 per cent (72.7 mmol/mol) were enrolled.

Patients randomly received metformin or placebo alongside their basal-bolus insulin regimen for 26 weeks. At 26 weeks, both groups experienced the same mean change in HbA1c levels.

However, at 26 weeks, the metformin group had lower mean total daily insulin doses compared to the placebo group. Throughout the duration of the study, the metformin group experienced a decrease in total daily insulin doses.

24 per cent of the metformin group showed a reduction in Body Mass Index (BMI) of 10 per cent from baseline. This figure was seven per cent in the placebo group.

"The reduction in body weight, or improved adiposity, as well as the significant reduction in insulin dose, are significant end points that will benefit patients in the long run," said Dutta.

While the results do not support prescribing metformin to overweight adolescents with type 1 diabetes, study author Ingrid Libman, MD, PhD, associate professor at Children's Hospital of Pittsburgh, Pennsylvania, added: "Knowing that we were not able to show that metformin really had an effect on glycemic control, I would say that emphasizing compliance with diabetes management overall is imperative."

Libman explained that treatment options such as regularly checking blood glucose levels, eating a healthy diet and getting regularly physical activity are vital for patients with type 1 diabetes, especially those who are overweight.

The findings were published in the Journal of the American Medical Association.
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