Failure of the biguanides to improve the control of unstable diabetes treated with insulin

Pirart, J

doi:10.1007/bf01211880

Cited by 17 publications

(11 citation statements)

References 6 publications

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“…Our findings seem to be at variance with the results of Perkins et al (4) who recently described intracellularly formed aragonite crystals in P. dumnetoslis. The size, morphology, and location of the crystals appear to be very similar to our calcium oxalate crystals.…”

supporting

confidence: 58%

Calcium Oxalate Crystals in the Aragonite-Producing Green Alga Penicillus and Related Genera

Friedmann

Roth

Turner

et al. 1972

Science

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Calcium oxalate crystals occur in the marine green algae Penicillus, Rhipocephalus, and Udotea, known as producers of sedimentary aragonite needles. In contrast to the externally deposited aragonite crystals which are generally < 15 micrometers long, the oxalate crystals are larger (up to 150 micrometers) and are located in the vacuolar system of the plant. No calcium oxalate was found in the related but noncalcifying genera Avrainvillea and Cladocephalus.

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supporting

confidence: 58%

Calcium Oxalate Crystals in the Aragonite-Producing Green Alga Penicillus and Related Genera

Friedmann

Roth

Turner

et al. 1972

Science

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“…It seemed more practical at that time to simply increase the insulin dosage in order to treat the DM 13 . However, it was noted that metformin when given together with insulin to patients with type 1 DM had an insulin sparing effect 7 " 12 .…”

Section: Discussionmentioning

confidence: 99%

Metformin Adjunctive Therapy with Insulin Improves Glycemic Control in Patients with Type 1 Diabetes Mellitus: A Pilot Study

Gómez

Mokhashi²,

Rao³

et al. 2002

Journal of Pediatric Endocrinology and Metabolism

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Metformin lowers blood glucose by reducing hepatic glucose output and improving insulin sensitivity without requiring an increase in circulating insulin concentration. We hypothesized that metformin could be used adjunctively with insulin to improve glycemic control in type 1 diabetes mellitus (DM). We conducted a 6-month open-label pilot study in 10 adolescents and young adults with type 1 DM, 19.1 +/- 3.4 years, 4 males, 6 females, and body mass index 26.3 +/- 3.1 kg/m2. Patients started metformin at a dose of 250 mg b.i.d.; the dose was increased until blood glucose was within an optimal target range or a maximum of 2,500 mg/d was reached. Insulin dose was reduced as needed to prevent hypoglycemia. Seven patients had an average decrease in HbA(1c) of 11% from pretreatment. These responders had no change in insulin dose, BMI or lipid levels during the study. Three patients had no improvement of HbA(1c) on therapy. We conclude that some patients with type 1 DM will have improved glycemic control on adjunctive metformin therapy. Evaluation of the long-term benefit and safety of adjunctive therapy in patients with type 1 DM is warranted.

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“…In total, 47 of these publications were judged to be relevant to metformin therapy in type 1 diabetes. Analysis of publications revealed: 17 were observational studies with no random allocation and/or no comparator group [18,22,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]; 11 were reviews, letters or commentaries [43][44][45][46][47][48][49][50][51][52][53]; two did not contain any quantitative estimates of effects [54,55]; one concerned an outcome (erythrocyte binding of insulin) not judged relevant [56]; and four were abstracts of papers subsequently published [57][58][59][60]. Of the remaining 12 publications, one concerned insulin-requiring type 2 diabetes rather than type 1 diabetes (noted after translation) [61], and one covered a treatment period of fewer than 7 days [62].…”

Section: Resultsmentioning

confidence: 99%

“…• Observational; no random allocation and/or comparator groups (n=17) [18,22,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] • Review, commentary, letter (n=11) [43][44][45][46][47][48][49][50][51][52][53] • Insufficient numerical data (n=2) [54,55] • No relevant outcome (n=1) [56] • Abstract of later paper (n=4) [57][58][59][60] • No evidence of type 1 diabetes after translation (n=1)…”

Section: Resultsmentioning

confidence: 99%

The use of metformin in type 1 diabetes: a systematic review of efficacy

et al. 2010

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Aims/hypothesis As adding metformin to insulin therapy has been advocated in type 1 diabetes, we conducted a systematic review of published clinical trials and clinical trial databases to assess the effects on HbA 1c , weight, insulin-dose requirement and adverse effects. Methods We constructed evidence tables and fitted a fixedeffects model (inverse variance method) in order to assess heterogeneity between studies and give a crude measure of each overall treatment effect. Results Of 197 studies identified, nine involved randomisation with informed consent of patients with type 1 diabetes to metformin (vs placebo or comparator) in either a parallel or crossover design for at least 1 week. We noted marked heterogeneity in study design, drug dose, age of participants and length of follow-up. Metformin was associated with reductions in: (1) insulin-dose requirement (5.7-10

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Failure of the biguanides to improve the control of unstable diabetes treated with insulin

Cited by 17 publications

References 6 publications

Calcium Oxalate Crystals in the Aragonite-Producing Green Alga Penicillus and Related Genera

Calcium Oxalate Crystals in the Aragonite-Producing Green Alga Penicillus and Related Genera

Metformin Adjunctive Therapy with Insulin Improves Glycemic Control in Patients with Type 1 Diabetes Mellitus: A Pilot Study

The use of metformin in type 1 diabetes: a systematic review of efficacy

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