The Curative Effect Of Metformin Of Insulin Resistance In Children

Objective: With the improvement of people’s living standard and life style change,the incidence of insulin resistance in children is in a rising trend, children’s insulinresistance has become a particular concern of doctors and their families around theworld. Insulin resistance (IR) is the pathological physiology foundation of abnormalglucose tolerance, centripetal obesity, lipid metabolism disorders, hypertension,hyperuricemia,type2diabetes, heart disease, metabolic syndrome to insulin resistance(IR),abnormal fibrinolysis,and even of polycystic ovary syndrome(PCOS).The studyreported that in China，the urban school-age children ’s incidence of obesity hasreached10%-20%and insulin resistance (IR) in the incidence of obese children hasreached approximately50%,The increase of obesity and type2diabetes in children, andchildren with nephrotic syndrome and other diseases accompanied by the application ofglucocorticoid-induced insulin resistance side effects are more and more obvious, thechildren’s insulin resistance has become a clinical needed to be solved problem. If wecan give early detection and diagnosis, and give early treatment, the adult incidence willgreatly reduced. This article through to the Second Affiliated Hospital of DalianMedical University’s Pediatrics part of insulin resistance of children, give metforminoral therapy, observe the metformin for the existence of the curative effect of insulinresistance of children, observe their adverse reactions and timely treatment.Methods: By selecting24cases of children in the Second Affiliated Hospital ofDalian Medical University Pediatrics from January2007to December2011werediagnosed with insulin resistance,10cases of children with simple obesity,14cases ofchildren with nephrotic syndrome in the application of glucocorticoid treatmentinduced insulin resistance. All were given metformin oral treatment for12weeks,observe before and after treatment fasting blood glucose, insulin, lipids index changes,calculation of insulin resistance index (HOMA-IR) in order to evaluate metformin to the curative effect of insulin resistance.In the process of drug attention whether childrenappear gastrointestinal reaction monitoring, skin rashes and other adverse reactions andtimely adjustment of drug dose and symptomatic treatment.Results: Oral metformin treatment group l2weeks compared with before treatment,the patient’s body mass index by treatment of before (25.5±2.1) to the treatment of after(23.8±1.48), TG before treatment by the (2.01±1.10)mmol/L drop to therapy (1.43±0.48) mmol/L, low density lipoprotein (LDL)-L) before treatment by the (3.30±0.57)mmol/L fell to therapy (2.75±0.44) mmol/L.Oral metformin treatment after12weekscompared with before treatment, metformin groups of children’s weight, body massindex (BMI), TG and low-density lipoprotein (LDL)-L) decreased, a significant fallbefore treatment, with a statistically significant (P <0.05).Oral metformin treatment group12weeks after treatment compared before,by thetreatment of fasting blood glucose before (5.5±0.3) mmol/L to therapy (4.6±0..4)mmol/L,insulin levels before treatment by the (29.7±4.0) IU/ml drop to therapy(15.4±4.4) IU/ml,insulin resistance index (HOMA_IR) before treatment by (4.3±1.5)fell to (3.1±1.6) after treatment.Oral metformin treatment group12weeks comparedwith before treatment,the patient’s fasting blood glucose,blood insulin levels,insulinresistance index(HOMA_IR) value dropped siginificantly,before and after treatmentcomparied with a statistically significant (P <0.05).In this study,24cases associated with insulin resistance in children givenmetformin treatment for12weeks, which18cases (75%) of children with insulinresistance index returned to normal,body weight compared with significantly decreased,no children happened allerge, anemia and other adverse reactions,only fivecases(21%)have abdominal discomfort and diarrhea,no other uncomfoetablereaction,but children can be tolerated.Conclusion: Metformin can improve glucose metabolic abnormalities, reduceweight and body fat and improve insulin resistance;Metformin for prevention ofhormone-induced obesity-associated nephropathy and simple obesity-induced insulinresistance have an important significance...