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Metformin may not help control blood sugar in obese teens with type 1 diabetes

While small improvements were seen early in the study with some patients, the results plateaued over the long term.

By
Stephen Feller
Although metformin was associated with reductions in weight gain, BMI, body fat, and total daily insulin dose when compared to a placebo, researchers were unsure of their clinical relevance. Photo by Image Point Fr/Shutterstock
Although metformin was associated with reductions in weight gain, BMI, body fat, and total daily insulin dose when compared to a placebo, researchers were unsure of their clinical relevance. Photo by Image Point Fr/Shutterstock

WASHINGTON, Dec. 2 (UPI) -- While metformin is used with overweight teens who have type 1 diabetes to prevent further weight gain related to the disease, a new study shows the drug does not improve glycemic control after six months of treatment.

Type 1 diabetes, a chronic, genetic condition characterized by the pancreas not making enough insulin to process sugar, requires high doses of insulin to overcome obesity and puberty, and can contribute to difficulties controlling blood sugar and further weight gains.

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Metformin, sold as Glucophage, is typically used with type 2 diabetes patients, in combination with insulin, to control blood sugar. Previous studies with type 1 diabetes patients, who also take it with insulin, have been inconclusive, though individual patient experiences have led doctors to continue using it, researchers said.

"These results do not support prescribing metformin to overweight adolescents with type 1 diabetes to improve glycemic control," researchers wrote in the new study, which is published in the Journal of the American Medical Association.

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The researchers recruited 140 teenagers between 12.1 and 19.6 years old at 26 pediatric endocrinology clinics, all of whom had been diagnosed with type 1 diabetes for a mean of 7 years, and had a BMI in the 94th percentile. The participants were randomized for treatment, with 71 receiving metformin and 69 receiving a placebo.

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During the first 13 weeks of the 26-week study, participants given metformin showed improvement in glucose management, but researchers reported this effect wore off as the study continued and they called it unlikely that glycemic control would have improved during a longer period of treatment.

The group treated with metformin also showed reductions in weight gain, BMI, body fat, and total daily insulin dose. The researchers said the clinical relevance between levels in the metformin and placebo group was uncertain.

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While the researchers conclude the study's results did not support continued use of the drug with type 1 diabetes patients, one New York City-based endocrinologist said although the drug's effects were not drastic, it decreased the amount of insulin patients used and was associated with mild weight loss.

"I think more randomized trials are needed before practicing physicians change their practice of using metformin in adolescent overweight type 1 diabetic patients," Dr. Spyros Mezitis of Lenox Hill Hospital told HealthDay.

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