A new perspective on metformin therapy in type 1 diabetes

Livingstone, Rachel; Boyle, James G.; Petrie, John R.

doi:10.1007/s00125-017-4364-6

Cited by 68 publications

(45 citation statements)

References 43 publications

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“…In Table 1 , we list the limitations of insulin therapy and the potential role of adjunctive non-insulin antidiabetic agents in type 1 diabetes. Pramlintide is approved for use in T1D, and several other anti-diabetic drugs have been investigated for their add-on role, including metformin, thiazolidinediones, DPP4 inhibitors, GLP-1 analogs, α-glucosidase inhibitors, SGLT2 inhibitors and dual SGLT1-SGLT2 inhibitors [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Review of Insulin Resistance in Type 1 Diabetes: Is There a Place for Adjunctive Metformin?

Priya

Kalra

2017

Diabetes Ther

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There is a rising trend of overweight and obesity among individuals with type 1 diabetes. This is often associated with insulin resistance, increased insulin dose requirements and poor glycemic control. Insulin resistance is also seen during puberty and is strongly related to increased risk of cardiovascular disease. The role of metformin as an adjunct to ongoing intensive insulin therapy in type 1 diabetics has been evaluated in several randomized trials, including the recently concluded T1D Exchange Network trial in adolescents and the REMOVAL trial in adults. Metformin reduces the insulin dose requirement, insulin-induced weight gain, and total and LDL cholesterol, but results in an increased risk of gastrointestinal adverse effects and a minor increase in the risk of hypoglycemia. In addition, metformin has been shown to reduce maximal carotid intima media thickness and therefore may extend cardioprotective benefits in type 1 diabetes. The role of metformin as adjunctive therapy in type 1 diabetes needs to be explored further in outcome trials.

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Section: Introductionmentioning

confidence: 99%

A Review of Insulin Resistance in Type 1 Diabetes: Is There a Place for Adjunctive Metformin?

Priya

Kalra

2017

Diabetes Ther

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“…In their review, Livingstone et al [24] outline evidence of metformin use in type 1 diabetes. Overall, studies suggest that metformin use does not lead to sustained improvements in glycaemic control but reduces insulin dose requirement, weight and, potentially, LDL-cholesterol.…”

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confidence: 99%

60 years of metformin use: a glance at the past and a look to the future

Marshall

2017

Diabetologia

114

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“…Metformin, a biguanide commonly used in management of T2DM has been used off-label in people with T1DM in an attempt to reduce effective insulin dose requirements and associated weight gain [ 28 ]. The current National Institute for Health and Care Excellence (NICE) guidelines for management of T1DM recommend considering metformin in adults with T1DM and a body mass index (BMI) ≥25 kg/m 2 who ‘want to improve glucose control while minimising their effective insulin dose’ [ 22 ].…”

Section: Use Of Metformin In T1dmmentioning

confidence: 99%

Recent Updates on Type 1 Diabetes Mellitus Management for Clinicians

2018

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Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition that requires life-long administration of insulin. Optimal management of T1DM entails a good knowledge and understanding of this condition both by the physician and the patient. Recent introduction of novel insulin preparations, technological advances in insulin delivery and glucose monitoring, such as continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring and improved understanding of the detrimental effects of hypoglycaemia and hyperglycaemia offer new opportunities and perspectives in T1DM management. Evidence from clinical trials suggests an important role of structured patient education. Our efforts should be aimed at improved metabolic control with concomitant reduction of hypoglycaemia. Despite recent advances, these goals are not easy to achieve and can put significant pressure on people with T1DM. The approach of physicians should therefore be maximally supportive. In this review, we provide an overview of the recent advances in T1DM management focusing on novel insulin preparations, ways of insulin administration and glucose monitoring and the role of metformin or sodium-glucose co-transporter 2 inhibitors in T1DM management. We then discuss our current understanding of the effects of hypoglycaemia on human body and strategies aimed at mitigating the risks associated with hypoglycaemia.

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A new perspective on metformin therapy in type 1 diabetes

Cited by 68 publications

References 43 publications

A Review of Insulin Resistance in Type 1 Diabetes: Is There a Place for Adjunctive Metformin?

A Review of Insulin Resistance in Type 1 Diabetes: Is There a Place for Adjunctive Metformin?

60 years of metformin use: a glance at the past and a look to the future

Recent Updates on Type 1 Diabetes Mellitus Management for Clinicians

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