Metformin as an adjunctive therapy is not formally recommended in type 1 diabetes unlike in type 2 diabetes. Until now, a limited number of studies have investigated the addition of metformin to insulin therapy in type 1 diabetics. The addition of metformin to insulin therapy in type 1 DM is still under debate. Metformin has been shown to increase insulin sensitivity and reduce metabolic syndrome incidence in people with prediabetes. In this respect, compared with insulin monotherapy, the addition of metformin to insulin therapy improves metabolic control and decreases complications in type 2 diabetes. Metformin leads to reduce insulin dose requirement as well as weight gain because it increases insulin sensitivity. Thus, it enhances insulin action and improves glycemic control. It increases both hepatic and peripheral insulin sensitivity in the liver by inhibiting basal hepatic glucose production, as well as in skeletal muscles and adipocytes, by increasing glucose uptake. Metformin is an oral anti-hyperglycemic agent and commonly used in the treatment of type 2 diabetes. Increased insulin dose requirement might cause weight gain and hypoglycemia, which might lead to noncompliance with therapy and ultimately poor glycemic control. Management of insulin resistance usually requires an increase in insulin dose requirement. Obesity, lack of exercise, and puberty are primary causes of insulin resistance in type 1 diabetes. Type 1 diabetes associated with metabolic syndrome has been termed as double diabetes. Metabolic syndrome is a clinical proxy for insulin resistance. Insulin resistance leads to poor glycemic control and chronic complications in type 1 diabetics. This effect contributes to the development of insulin resistance. Insulin-stimulated skeletal muscle glucose uptake as well as insulin action reduces in type 1 diabetics. Standard insulin therapy in type 1 diabetes has been associated with increased complications including hypoglycemia, weight gain, and dyslipidemia. These results were independent of blood lipid improvement or weight loss, although on average weight remained decreased with metformin-insulin therapy, whereas the average weight increased with insulin therapy alone.ĭespite intensive insulin therapy, target hemoglobin A 1c (HbA 1c) levels remain above 7.0% in many patients with type 1 diabetes mellitus (DM) with poor metabolic control. Metformin decreased glucose concentrations, reduced metabolic syndrome, as well as insulin dose requirement more than insulin therapy alone, 1 year after treatment. Body weight, lipids, and HbA1c did not differ between the groups ( p > 0.05). −3.1 ± 40.1 mg/dL, p = 0.010) was more decreased in the metformin-insulin group than in the insulin alone group. Insulin dose requirement was lower in the metformin-insulin group than in the insulin alone group (−0.03 vs. Metabolic syndrome was more decreased in the metformin-insulin group than in the insulin alone group after treatment (−8.9 ± 1.3 vs. Metabolic syndrome (44.8 vs 41.4%, p > 0.05) did not differ between the metformin-insulin and insulin alone groups before treatment. Age, sex, body weight, insulin dose requirement, plasma glucose (PG), blood pressure (BP), and lipids did not differ between groups before treatment ( p > 0.05). Resultsįifty-eight patients with C peptide negative-type 1 diabetics (26 females, mean age: 29.01 ± 7.03 years, BMI: 24.18 ± 3.16 kg/m2) were analyzed. Twenty-nine adults with type 1 diabetes who had metformin added to their insulin therapy for 12 months were compared with 29 adults with type 1 diabetes who remained on insulin-alone therapy. This retrospective study investigated the effect of adding metformin to pharmacologic insulin dosing in type 1 diabetics on insulin therapy 1 year after treatment compared with patients on insulin therapy alone.
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