Printer Friendly

Metformin did not improve glycemic control in type 1.

Add-on metformin therapy did not improve glycemic control in overweight adolescents with type diabetes, according to a report published online Dec. 1 in JAMA.

Even though patients with type 1 diabetes are traditionally thought of as being underweight or of healthy weight, the percentage who are overweight or obese is increasing in this patient population as it is in the general population. Being overweight or obese has serious metabolic consequences for patients with diabetes, particularly during adolescence, said Dr. Ingrid M. Libman, a pediatric endocrinologist at the Children's Hospital of Pittsburgh, and her associates.

They assessed the effect of adding oral metformin (2,000 mg/day) to insulin therapy in a double-blind placebo-controlled trial involving 140 patients aged 12-19 years (mean age, 15.3 years) at 26 U.S. clinics. The study participants were overweight or obese and had had type 1 diabetes for a mean of 7 years.

The primary efficacy outcome--change in hemoglobin [A.sub.1c] level after 6 months of adjunctive metformin (71 patients) or matching placebo (69 patients)--was exactly the same, with an increase of 0.2% in both study groups. Continuous glucose monitoring confirmed that there were no significant differences between the two study groups in glycemic control.

Compared with patients taking placebo, those taking metformin showed a slight reduction in total daily insulin dose and a slightly lower weight gain. "The clinical relevance of these treatment group differences is uncertain," Dr. Libman and her associates wrote (JAMA, 2015 Dec 1. doi: 10.1001/jama.2015.16174). There were no differences between the two groups in blood pressure, lipid profiles, or inflammatory markers.

Patients taking metformin reported significantly more adverse gastrointestinal events than those taking placebo. And severe hypoglycemia developed in five patients taking metformin, compared with none who were taking placebo.

"These results do not support prescribing metformin to adolescents to improve glycemic control," the investigators wrote.



COPYRIGHT 2015 International Medical News Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2015 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:DIABETES
Author:Moon, Mary Ann
Publication:Family Practice News
Article Type:Report
Date:Dec 1, 2015
Previous Article:Empagliflozin spared kidney function in 2DM.
Next Article:Hepatitis C treatment capacity falls short of need.

Terms of use | Privacy policy | Copyright © 2018 Farlex, Inc. | Feedback | For webmasters