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Metformin in type 1 diabetes
Author(s) -
Connelly Paul,
McKay Gerry,
Petrie John R
Publication year - 2015
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.1954
Subject(s) - medicine , metformin , type 2 diabetes , insulin , diabetes mellitus , endocrinology , population , metabolic control analysis , macrovascular disease , environmental health
Type 1 diabetes is a disorder of immune tolerance affecting insulinproducing beta cells in the islets of Langerhans. Intensive insulin therapy is the foundation of clinical care in accordance with evidence of reduced long-term complications from the Diabetes Control and Complications Trial (DCCT).1 However, this approach is associated with the increased frequency and severity of hypoglycaemia as well as weight gain. Moreover, despite advances in glucose monitoring and insulin delivery, population-based data indicate that HbA1c remains poorly controlled in many individuals with reduced life expectancy of 11 years in men and 13 years in women.2,3 Adjunct therapy with insulin sparing pharmacological agents has been proposed as a means of improving metabolic control while minimising insulin’s unwanted effects. Metformin is a drug with potential in this context. It is widely considered to be the first-line oral glucose-lowering agent for the treatment of type 2 diabetes following evidence of cardiovascular benefit in a sub-study of the UK Prospective Diabetes Study (UKPDS). Moreover, addition of metformin to insulin in individuals with type 2 diabetes in the HOME trial (Hyperinsulinemia: the Outcome of its Metabolic Effects) attenuated weight gain, reduced insulin dose requirements, improved glycaemic control, and reduced rates of macrovascular disease (a secondary endpoint).