Effect of Metformin in Pediatric Patients With Type 2 Diabetes

Jones, Kenneth L.; Arslanian, Silva; Peterokova, Valentina A.; Park, Jong-Soon; Tomlinson, M. Joseph

doi:10.2337/diacare.25.1.89

Cited by 363 publications

(239 citation statements)

References 10 publications

(4 reference statements)

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“…In December 2000, the US Food and Drug Administration (FDA) approved the use of metformin for children with T2D. Studies have not been conducted in children younger than 10 years of age [57,58]. MALA is a possible side effect, but it seems to be a rare event.…”

Section: Pathophysiologymentioning

confidence: 99%

Drug-induced acid-base disorders

et al. 2014

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The incidence of acid-base disorders (ABDs) is high, especially in hospitalized patients. ABDs are often indicators for severe systemic disorders. In everyday clinical practice, analysis of ABDs must be performed in a standardized manner. Highly sensitive diagnostic tools to distinguish the various ABDs include the anion gap and the serum osmolar gap. Drug-induced ABDs can be classified into five different categories in terms of their pathophysiology: (1) metabolic acidosis caused by acid overload, which may occur through accumulation of acids by endogenous (e.g., lactic acidosis by biguanides, propofol-related syndrome) or exogenous (e.g., glycol-dependant drugs, such as diazepam or salicylates) mechanisms or by decreased renal acid excretion (e.g., distal renal tubular acidosis by amphotericin B, nonsteroidal antiinflammatory drugs, vitamin D); (2) base loss: proximal renal tubular acidosis by drugs (e.g., ifosfamide, aminoglycosides, carbonic anhydrase inhibitors, antiretrovirals, oxaliplatin or cisplatin) in the context of Fanconi syndrome; (3) alkalosis resulting from acid and/or chloride loss by renal (e.g., diuretics, penicillins, aminoglycosides) or extrarenal (e.g., laxative drugs) mechanisms; (4) exogenous bicarbonate loads: milk-alkali syndrome, overshoot alkalosis after bicarbonate therapy or citrate administration; and (5) respiratory acidosis or alkalosis resulting from drug-induced depression of the respiratory center or neuromuscular impairment (e.g

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Section: Pathophysiologymentioning

confidence: 99%

Drug-induced acid-base disorders

et al. 2014

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“…One randomized, double-blind trial in children and adolescents with type 2 diabetes demonstrated similar antihyperglycemic benefits to those observed in adults. 96 These data underpinned an indication for the use of metformin in pediatric type 2 diabetes in Europe and in the United States. Mean weight gain did not differ between metformin and placebo groups.…”

Section: Pediatric Obesitymentioning

confidence: 99%

Metformin and body weight

2007

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Most patients with type 2 diabetes are overweight or obese, overweight or obesity increases the risk of developing type 2 diabetes and obesity per se is strongly associated with multiple cardiometabolic risk factors. However, many antidiabetic treatments increase body weight. The oral antidiabetic agent, metformin, has been evaluated in hundreds of clinical studies in diverse patient populations during approximately five decades of clinical use. This review summarizes the effects of metformin on body weight, with special reference to studies of longer duration (X6 months) as both diabetes and obesity are long-term conditions. Approximately half of studies in drug-naive type 2 diabetic patients demonstrated significant weight loss with metformin compared with baseline or comparator drugs, although pooled analyses have suggested no significant effect versus placebo. Similarly, metformin has been shown to induce weight loss in obese nondiabetic populations, although studies of long duration in this population are scarce. Metformin does appear to mitigate the adverse effects of insulin on body weight. The weight-neutral or weight-sparing effects of metformin constitute a therapeutic advantage in diabetes management where other first-line oral antidiabetic treatments often promote clinically significant weight gain.

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“…In the multicenter trial on metformin in pediatric patients with T2DM, 29 besides 62 children from US, 16 children from Russia, four from Ukraine, two from Belarus and one from Poland were included. Their age ranged from 10 to 17 y and over 80% were obese or overweight.…”

Section: Prevalence Of Type 2 Diabetes Mellitus In Childrenmentioning

confidence: 99%

The prevalence of the metabolic syndrome and type 2 diabetes mellitus in children and adolescents

Molnár

2004

Int J Obes

103

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OBJECTIVE:To review the prevalence of the metabolic syndrome and type 2 diabetes in children and adolescents. METHOD: Literature review. RESULTS: It is well demonstrated that cardiovascular risk factors are frequent in childhood obesity and they tend to cluster. However, the frequency of the metabolic syndrome in childhood and adolescence has been investigated only by few studies. In spite of the diverse criteria used for defining the metabolic syndrome, it is evident that the syndrome is already highly prevalent among obese children and adolescents. Population-based data suggest that the epidemic of pediatric obesity is being followed by an increase of type 2 diabetes mellitus, especially in the United States and in minorities. For the European countries, there are no population-based incidence and prevalence data concerning type 2 diabetes mellitus in children and adolescents. From the available data, the magnitude of the problem in the European Caucasian population seems to be much less than in North America. CONCLUSION: There is an urgent need to establish internationally acceptable criteria for the metabolic syndrome in children and adolescents and to commence screening for this syndrome. Although type 2 diabetes mellitus is still rare among European children, screening is recommended for type 2 diabetes mellitus or impaired glucose tolerance in children and especially in adolescents with substantial risk for the development of this disease.

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Effect of Metformin in Pediatric Patients With Type 2 Diabetes

Cited by 363 publications

References 10 publications

Drug-induced acid-base disorders

Drug-induced acid-base disorders

Metformin and body weight

The prevalence of the metabolic syndrome and type 2 diabetes mellitus in children and adolescents

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