| Our study aimed to determine whether metformin added to insulin would improve insulin sensitivity (Si) and metabolic control in adolescents with type 1 diabetes (T1DM). We performed a randomized, placebo-controlled trial of 3 months of metformin therapy in 27 adolescents with T1DM, high insulin dose and high hemoglobin A1c (HbA1c), with measurements of Si (by frequent sampled IV glucose tolerance test), HbA1c, insulin dose and BMI at 0 and 3 months.; At time 0, mean HbA1c was 9.2 ± 0.9%. At study end, mean change in HbA1c was 0.6% lower in the Metformin group compared to Placebo (p < 0.05). This was achieved at lower insulin doses (metformin −0.14 ± 0.1 versus placebo +0.02 ± 0.2 U/kg/day; p < 0.05). Si did not change significantly between the two groups. In conclusion, Metformin lowers HbA1c, decreases insulin dose with no weight gain in teens with T1DM in poor metabolic control and pubertal insulin resistance. |
