Type 2 treatments for type 1 diabetes

Bloomgarden, Zachary T.; Ning, Guang

doi:10.1111/1753-0407.12430

Cited by 2 publications

(4 citation statements)

References 31 publications

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“…5 Weight gain is supposed to be associated with increasing risk of cardiovascular disease. 6,7 The prevalence of overweight or obesity has been increasing among patients with T1DM in Western countries, 8 as reported by the T1D Exchange and the Diabetes Prospective Followup (Diabetes Patienten Verlaufsdokumentation, DPV) studies. 9,10 With the increasing prevalence of obesity, insulin resistance has become more frequent in patients with T1DM.…”

Section: Introductionmentioning

confidence: 99%

“…9,13 Clinical trials and meta-analyses suggested that metformin added to insulin can reduce daily insulin dosage and body weight, but with no effect on glycemic control in patients with T1DM. 8,[14][15][16] In addition, the REMOVAL study suggested that metformin could reduce low-density lipoprotein (LDL) cholesterol and might delay the progression of atherosclerosis, which suggests that it might play a role in cardiovascular disease management in patients with T1DM. 17 Up till now, limited data on the efficacy and safety of the additional metformin therapy in Chinese patients with T1DM were available under real-life conditions.…”

Section: Introductionmentioning

confidence: 99%

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Current status of metformin in addition to insulin therapy in adult patients with type 1 diabetes mellitus: An analysis from the Guangdong Type 1 Diabetes Mellitus Translational Medicine Study

Qiu

Ling

Yang

et al. 2020

Journal of Diabetes

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Background Limited data on the efficacy of the additional metformin therapy in patients with type 1 diabetes mellitus (T1DM) under real‐life conditions have been available so far. Methods Patients aged ≥18 years with a duration of T1DM for at least 1 year were included in this multicenter observational study. Patients with insulin combined with metformin therapy (MET group) were compared with those with insulin therapy only (INS group). Results A total of 76 patients in the MET group were compared with 655 patients in the INS group. At baseline, patients with dyslipidemia were more prevalent in the MET group (17.6% vs 9.0%; P = .006), and they also had a higher body mass index (BMI) (21.7 ± 3.2 kg/m2 vs 20.4 ± 2.6 kg/m2; P < .001) than those in the INS group. But glycosylated hemoglobin (HbA1c) and daily insulin dose were not significantly different between the two groups. After 1‐year follow‐up, HbA1c decreased in both groups, while the daily insulin dose decreased in the MET group, but did not change in the INS group (−0.02 IU/kg [−0.16, 0.09] vs 0 IU/kg [−0.09, 0.09]; P = .029). The additional metformin therapy led to no change of BMI and weight in the MET group, while the body weight increased from 53.7 ± 8.6 kg to 55.0 ± 7.9 kg in the INS group (P < .001). Conclusions Metformin is initiated more in T1DM patients with dyslipidemia or higher BMI in current practice in China. The addition of metformin is effective in maintaining weight and reducing the insulin dosage without improving glycemic control in patients with T1DM.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current status of metformin in addition to insulin therapy in adult patients with type 1 diabetes mellitus: An analysis from the Guangdong Type 1 Diabetes Mellitus Translational Medicine Study

Qiu

Ling

Yang

et al. 2020

Journal of Diabetes

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“…Despite these attempts, the current situation is far from satisfactory ( 19 , 20 , 21 ). Previous clinical studies and meta-analyses have reported that metformin, as an adjuvant therapy to T1DM, has minimal benefits for glycemic control ( 7 , 16 , 18 , 22 , 23 ). Conversely, new evidence has revealed modest improvements in the HbA1c level of T1DM patients with adjuvant metformin therapy.…”

Section: Discussionmentioning

confidence: 99%

“…However, the titration of increased insulin dosage is usually accompanied by weight gain and glycemic variability (GV). Further, with the increasing prevalence of obesity and overweight in patients with T1DM ( 7 , 8 ), insulin resistance (IR) considered to increase the CVD risk has become prominent in these individuals ( 9 , 10 ). Moreover, a culmination of evidence proposes that GV is integral in predicting adverse clinical outcomes in patients with diabetes, including hypoglycemia, diabetic complications as well as mortality ( 11 ), emerging as one of the core treatment targets of potential therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial

Zhang

et al. 2021

Endocrine Connections

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Introduction: Metformin has been demonstrated to enhance cardioprotective benefits in type 1 diabetes (T1DM). Although glycemic variability (GV) is associated with increased risk of CVD in diabetes, there is a scarcity of research evaluating the effect of metformin on GV in T1DM. Objectives: In the present study, the effects of adjuvant metformin therapy on GV and metabolic control in T1DM were explored. Patients and methods: A total of 65 adults with T1DM were enrolled and subjected to physical examination, fasting laboratory tests and continuous glucose monitoring, and subsequently randomized 1:1 to 3 months of 1000- 2000 mg metformin daily add-on insulin (MET group, n=34) or insulin (Non-MET group, n=31). After, baseline measurements were repeated. Results: The mean amplitude of glycemic excursions was substantially reduced in MET group, compared with Non-MET group [-1.58 (-3.35,0.31) mmol/L versus 1.36 (-1.12,2.24) mmol/L, P=0.004]. In parallel, the largest amplitude of glycemic excursions [-2.83 (-5.47,-0.06) mmol/L versus 0.45 (-1.29,4.48) mmol/L, P=0.004], the standard deviation of blood glucose [-0.85 (-1.51,0.01) mmol/L versus -0.14 (-0.68,1.21) mmol/L, P=0.015], and the coefficient of variation [-6.66 (-15.00,1.50) % versus -1.60 (-6.28,11.71) %, P=0.012] all demonstrated improvement in the MET group, compared with the Non-MET group. Significant reduction in insulin dose, body mass index and body weight were observed in patients in MET, not those in Non-MET group. Conclusion: Additional metformin therapy improved GV in adults with T1DM, as well as improving body composition and reducing insulin requirement. Hence, metformin as adjunctive therapy has potential prospects in reducing the CVD risk in patients with T1DM in the long term.

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Type 2 treatments for type 1 diabetes

Cited by 2 publications

References 31 publications

Current status of metformin in addition to insulin therapy in adult patients with type 1 diabetes mellitus: An analysis from the Guangdong Type 1 Diabetes Mellitus Translational Medicine Study

Current status of metformin in addition to insulin therapy in adult patients with type 1 diabetes mellitus: An analysis from the Guangdong Type 1 Diabetes Mellitus Translational Medicine Study

Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial

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